"CLIPPING INJURY" FRACTURE OF THE EPIPHYSIS IN THE ADOLESCENT FOOTBALL PLAYER: AN OCCULT LESION OF THE KNEE

¹ Associate Professor of Radiology, Houston, Texas.
² Resident in Orthopedics, Houston, Texas.
³ Clinical Associate Professor of Orthopedic Surgery, Houston, Texas.
⁴ Assistant Professor of Radiology, Dallas, Texas.

The physician should be alert to the possibility of an underlying epiphyseal injury in an adolescent when a ligamentous injury of the knee is suspected clinically. This is especially true when a valgus force was sustained, as in a clipping injury in football, and a rupture of the medial collateral ligament is suspected. Under these circumstances, if the standard anteroposterior and lateral projections of the knee are unrevealing, oblique and notch views should be obtained. If these are also unrevealing, a valgus stress examination should be performed.

This report is based upon 8 cases, 7 involving the distal femoral and 1 the proximal tibial epiphyses.

Anatomic dissections were performed and experimental injuries were produced in rabbit specimens to determine the anatomic relationships between the growth plate, ligaments, and the epiphyseal fractures.

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