Avulsion Fracture of the Tibial Tubercle Associated With Patellar Tendon Avulsion

Clarke, Daine O; Franklin, Safiya A; Wright, Dean E

doi:10.3928/01477447-20160414-02

Cited by 20 publications

(24 citation statements)

References 13 publications

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“… 8 Seo et al 9 reported that this same treatment was used successfully in a 14-year-old patient. The present results were similar to those of previously published studies 9 , 10 , 11 on this injury; 12 months after the injury, the patient was able to return to the sports activities without subjective symptoms or weakness of the extensor mechanism.…”

Section: Discussionsupporting

confidence: 92%

Tibial tubercle fracture associated with distal rupture of the patellar tendon: case report

Pereira

Faria

Campos

et al. 2018

Revista Brasileira de Ortopedia (English Edition)

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Avulsion of the tibial tubercle is an uncommon injury that occurs in the young athlete, resulting from an eccentric contraction of the extensor mechanism with the leg fixed to the ground. Concomitant injuries to the patellar tendon are very rare, with few cases reported in the literature. The authors present a case of a 15-year-old basketball player who suffered an avulsion of the tibial tubercle associated with complete distal rupture of the patellar tendon while training. It was treated with open reduction of the tibial fragment and reconstruction of the patellar tendon with mini-anchors and cannulated screws, as well as hamstring autograft tendon reinforcement. The patient showed excellent results and returned to sports after 12 months of follow-up.

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Section: Discussionsupporting

confidence: 92%

Tibial tubercle fracture associated with distal rupture of the patellar tendon: case report

Pereira

Faria

Campos

et al. 2018

Revista Brasileira de Ortopedia (English Edition)

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“…Mosier and Stanitski observed this type of fracture in 2 cases of tibial tubercle avulsion fractures in a study reviewing 19 of these fractures in 18 patients [ 1 ]. Many of the documented cases of these bipolar fractures occur in association with a jump, as seen with our patients, with basketball or track as two of the most commonly associated sports [ 3 – 5 ]. Our two cases are consistent with the jumping mechanism, and provide two examples of operative management of these injuries ( Table 1 ).…”

Section: Discussionmentioning

confidence: 91%

Two cases of combined patellar tendon avulsion from the tibia and patella

Bradko

Stoll

Haruno

et al. 2018

SICOT-J

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Avulsion fractures of the inferior pole of the patella and proximal tibial apophysis are independently rare injuries. They occur in children due to the relative weakness of the apophyseal cartilage compared to the ligaments and tendons. The combination of these two fractures, is exceedingly rare, with only a few previously described cases in the literature. Due to the infrequent presentation of this injury, careful examination and consideration of advanced imaging is important for diagnosis and preoperative planning. Here we present two cases of combined sleeve fractures of the inferior pole of the patella and tibial apophysis, with discussion of the pathophysiology, classification, identification and management of the injury.

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“…Limited range of motion due to pain or effusion from the avulsed tubercle can cause the variation in reported incidence. The presence of a palpable defect between the inferior pole of the patella and tibial tuberosity should heighten clinical suspicion for associated patellar tendon rupture [ 7 ]. If physical examination cannot be performed due to cast immobilization or pain, the presence of patella alta on radiographic imaging as well as calcified fragments below the patella may indicate the presence of patellar tendon rupture [ 7 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…Tibial tubercle avulsion fractures are managed operatively in most cases, and long-term outcomes are favorable with the resumption of sport to the previous level [ 4 ]. The high energy nature of the athletic injury is associated with compartment syndrome from bleeding into the anterior compartment, vascular injury [ 6 ], patellar tendon avulsion [ 7 ], and meniscal injury—exhibited only with fracture types that extend intra-articularly [ 8 ]. While there are various concomitant injuries, patients experiencing more than one concurrent injury with tibial tubercle avulsion fracture have not been reported in the literature.…”

Section: Introductionmentioning

confidence: 99%

Tibial Tubercle Avulsion Fracture with Multiple Concomitant Injuries in an Adolescent Male Athlete

Agarwalla

Puzzitiello

Stone

et al. 2018

Case Reports in Orthopedics

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Tibial tubercle avulsion fractures are an uncommon injury occurring due to strong contraction of the quadriceps femoris muscle during leg extension, ultimately causing failure of the physis at the patellar tendon insertion. This injury has been previously reported with various concomitant injuries, such as compartment syndrome from bleeding into the anterior compartment, vascular injury, patellar tendon avulsion, and meniscal injury—exhibited only with fracture types that extend intra-articularly. We report the case of a 14-year-old healthy adolescent male basketball player who sustained this injury as a result of a collision with another player. He initially reported to the emergency department and then presented to our practice, where he was diagnosed with a tibial tubercle avulsion fracture with patellar tendon rupture. During the operative management of these injuries, it was noted that fascial tissue avulsed through the injury site causing subacute extensive bleeding within the anterolateral compartments. Due to concerns of compartment syndrome, a fascial release was performed along the anterolateral compartments. By five months postoperatively, the patient demonstrated near-normal function, no evidence of extensor lag, and nearly full range of motion. Unlike previously reported cases, this is the first report of a patient who suffered such an injury with multiple concomitant injuries to the neighboring structures. Due to the severity of compartment syndrome and the variability in its temporal presentation from the initial injury, it is paramount that careful evaluation of vascular integrity and a low threshold for fasciotomy be in place to prevent vascular compromise.

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Avulsion Fracture of the Tibial Tubercle Associated With Patellar Tendon Avulsion

Cited by 20 publications

References 13 publications

Tibial tubercle fracture associated with distal rupture of the patellar tendon: case report

Tibial tubercle fracture associated with distal rupture of the patellar tendon: case report

Two cases of combined patellar tendon avulsion from the tibia and patella

Tibial Tubercle Avulsion Fracture with Multiple Concomitant Injuries in an Adolescent Male Athlete

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