Adolescent Tibial Tubercle Fracture: Review of Outcomes and Complications

Abstract

Purpose of Review Fractures of the tibial tubercle are a relatively uncommon injury, representing 3% of all proximal tibia fractures and < 1% of all physeal fractures, primarily seen in the adolescent demographic. While recognition of the injury and its management is being more widely reported in the literature and recognized in the hospital setting, reports of its outcomes and complications have still been limited. This article provides an updated review of the outcomes and complications of tibial tubercle fractures. Recent Findings Current research shows both radiographic outcomes, specifically osseous union, and functional outcomes, such as return to play and full knee range of motion, are excellent in patients treated either operatively or nonoperatively. Complication rates overall remain relatively low, with the most common complication being bursitis and hardware prominence and the most common associated injuries being patellar tendon avulsions and meniscus tears. Summary With appropriate management, tibial tubercle fractures have an excellent overall outcome and a low complication rate. Although complications are uncommon, treating providers should be vigilant and recognize the signs of devastating complications resulting from acute vascular injuries or compartment syndrome. Further research should aim to analyze patients’ experiences and satisfaction following treatment of this injury and examine the long-term functional and patient-reported outcomes.

Utilizing Suture Anchors in Addition to Screws for Treatment of Tibial Tubercle Avulsion Fracture: A Case Report

“…Kalifis et al reported fracture union in 99.8% of cases, regardless of the fracture type and treatment [ 14 ]. Furthermore, the overall complication rate is low, and the outcomes are considered excellent [ 6 , 16 ]. Our case also resulted in a successful outcome.…”

“…In 2023, Zukotynski et al reported on 71 patients who were treated with unicortical screws, and all had adequate healing and returned to full activities [12]. Given the rarity of this complication, it is inconclusive as to which screw is superior [6].…”

“…When the fracture is dislocated or involves the articular surface, open reduction and internal fixation (ORIF) are indicated [2]. Various fixation techniques using screws, tension band wiring, or sutures have been reported; however, there is no golden standard for this fracture [2][3][4][5][6]. Here, we report a case of displaced tibial tubercle avulsion fracture successfully managed with a small screw combined with a suture anchor, and we provide a review of previously reported techniques.…”