Figure 1 M A 1983 CMCC graduate, Dr. Marshall Deltoff completed his radiology residency at Los Angeles College of Chiro- practic. He is a past radiology department chairman and res- idency coordinator at CMCC, and he initiated the radiology curriculum at UQTR. Dr. Deltoff has lectured throughout North America, and is co-author, along with Dr. Peter Kogon, DACBR, of the radiology text “The Portable Skeletal X-ray Library” published by Mosby- Yearbook of St. Louis. Dr. Deltoff can be reached at: Images Radiology Consultants, 16 York Mills Road, Toronto, ON M2P 2E5 Tel: (416) 512-2225 Fax: (416) 512-2226 e-mail: [email protected] y sincere thanks to my friend and classmate, Dr. Vince Campo of Toronto, and his son Salvatore (Fig. 1), for sharing this case. Salvatore, age 12, was at a friend’s home and they were playing in the pool. He went on the diving board and was bouncing up and down. In the process he felt a snap in his knee and he fell into the pool. At that point in time, he was unable to stand completely on his knee joint and he had immediate swelling which seemed to go down with application of ice. However, he was unable to fully extend his knee. The knee was quite swollen and Sal was taken to the Emergency Depart- ment. Radiographic examination (Fig. 2) demonstrated a high-riding patella with a fragment of bone, and his clinical exam suggested the potential for patellar tendon rupture. In surgery, it was discovered that, not only did he fracture the tibial tuberosity at its growth plate but he also split his patellar tendon, and additionally had a fracture of the anterior growth plate of the proximal tibia. Surgery involved reattachment of the fracture fragment and the quadriceps mechanism, as well as repair of the torn patellar tendon. Post-surgical radiographs (Figs. 3 and 4) demonstrate the hardware used to re-stabilize Sal’s knee. DR. CAMPO EXPLAINS HIS SON’S REHAB: During the first six weeks, Salvatore was in a Zimmer brace. Cryotherapy was applied four times a day. In order to prevent adhesions and minimize the scar tissue formation, I utilized Nimmo Receptor Tonus, Myofascial Release, and Graston 38 • CANADIAN CHIROPRACTOR | DECEMBER 2007 Figure 2 Figure 3 Figure 4 www.canadianchiropractor.ca Marshall Deltoff, DC, DACBR, FCCR(C)
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