IS Case 316: Avulsion fracture of the tibial tubercle
Imaging Sciences URMC 2009
Publication Date: 2009-09-14
Patient is a 15-year-old male with acute knee pain while playing basketball.
Avulsion of the tibial tubercle is an uncommon fracture of the tibia that occurs in adolescents. Patients usually give a history of forceful quadriceps contraction during knee extension, such as in jumping, or by acute passive flexion of the knee against a contracting quadriceps, like landing after a jump. Given this mechanism, the injury is usually associated with athletics. Differentiation from Osgood-Schlatter disease is essential if tibial tubercle avulsion is suspected.
IB:Type IA but communited
IIB:Type IIA but communited
IIIB:Type IIIA but communited
Treatment includes anatomic reduction of the fracture, return of extensor alignment, and obtain an adequate tibial articular surface. Closed reduction and immobilization is usually performed for Types IA, IB, and IIA fractures. Types IIB, IIIA and B, and Type IV should have an open reduction and internal fixation to return extensor alignment and to obtain good articular congruency. Prognosis is excellent but complications include genu recurvatum, patella baja, nonunion, malunion, compartment syndrome, and deep venous thrombosis.
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- Hand WL, Hand CR, Dunn AW. Avulsion fractures of the tibial tubercle. J Bone Joint Surg Am. 1971 Dec;53(8):1579-83. PMID: 5121798