Fracture of tibial tuberosity in an adult

Abstract

SUMMARYThe fracture of tibial tuberosity is a rare lesion and still more unusual in adults. We describe a case in an adult who suffered a left knee injury due to a fall from height. No risk factors were identified. The lesion was treated with surgical reduction and internal fixation. The rehabilitation method was successful, resulting in excellent function and rage of motion of the knee. The aim of this study was to present an unusual case of direct trauma of the tibial tuberosity in an adult and the therapy performed. BACKGROUND

Osgood-Schlatter Disease as a Possible Cause of Tibial Tuberosity Avulsion

“…The prevalence of this condition among the adolescent population is estimated to be approximately 9.8%, with a male predominance [3]. Following diagnosis, activity restrictions are recommended to allow for proper healing and avoid possible complications, including tibial tuberosity fracture and compartment syndrome [2][3][4][5][6]. While tuberosity avulsion fractures make up only 3% of all proximal tibial fractures, and generally less than 1% of all physeal injuries, the frequency of this complication of OSD is not well defined in the literature [4][5][6].…”

“…Following diagnosis, activity restrictions are recommended to allow for proper healing and avoid possible complications, including tibial tuberosity fracture and compartment syndrome [2][3][4][5][6]. While tuberosity avulsion fractures make up only 3% of all proximal tibial fractures, and generally less than 1% of all physeal injuries, the frequency of this complication of OSD is not well defined in the literature [4][5][6]. OSD is nevertheless frequently discussed as a predisposing factor for these injuries, especially in adolescents with continued activity against recommended restrictions [2,4,[6][7][8][9][10].…”

“…While tuberosity avulsion fractures make up only 3% of all proximal tibial fractures, and generally less than 1% of all physeal injuries, the frequency of this complication of OSD is not well defined in the literature [4][5][6]. OSD is nevertheless frequently discussed as a predisposing factor for these injuries, especially in adolescents with continued activity against recommended restrictions [2,4,[6][7][8][9][10]. Case series demonstrating 20-75% of adolescents with tibial avulsion fractures were previously diagnosed with OSD [7,10].…”

“…Like OSD, tibial tuberosity avulsion fractures result from a sudden and violent contraction of quadriceps muscles placing severe strain on the patellar tendon which overcomes physeal strength [ 2 , 4 , 5 , 6 , 11 ]. This mechanism becomes more prevalent in later years of adolescence [ 8 , 12 ].…”

Tibial Plateau Fracture with Avulsion Fracture of Tibial Tuberosity: A Case Report and Review of Literature

“…The incidence of tibial tuberosity fracture is only 3% among proximal tibia fractures [2,3]. It is more common in the adolescent age groups when the muscle, ligament, and tendons are stronger than bone [4]. In adolescent groups, this fracture is mainly due to jumping and tackling activities [5].…”