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

Carius, Brandon M; Long, Brit

doi:10.7759/cureus.13256

Cited by 3 publications

(3 citation statements)

References 19 publications

(50 reference statements)

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“…8 To the best of our knowledge, there are some case reports of patients with preexisting OSD before the development of TTAF, but these reports did not discuss the relationship between the two in detail. [20][21][22][23] In this current case, a rare low-energy injury induced TTAF. It is our opinion that OSD damages the tendon-bone junction of the patellar tendon and the tibia, which greatly increases the risk of TTAF.…”

Section: Discussionmentioning

confidence: 82%

Tibial tubercle avulsion fracture following preexisting Osgood-Schlatter disease in an adolescent: a case report

Zhao,

Zhang,

Zhou

et al. 2024

J Int Med Res

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Tibial tubercle avulsion fractures (TTAFs) are rare but typical in children and adolescents and Osgood-Schlatter disease (OSD) may be involved in their pathogenesis. However, few publications have reported the relationship between OSD and TTAF. A 16-year-old healthy male adolescent presented with pain, swelling and limited range of motion of the right knee following sudden acceleration while running. Based on the radiographic evidence, the patient was diagnosed with an avulsion fracture of the right tibial tubercle and OSD. Open reduction and internal fixation were performed using two cannulated screws and two Kirschner wires. The patient returned to preinjury activity levels at the 12-month follow-up postoperatively. This case report aimed to highlight this unique injury pattern. For patients with TTAFs, not only should the fracture be treated, but the cause of the fracture, such as OSD, should also be given appropriate treatment.

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Section: Discussionmentioning

confidence: 82%

Tibial tubercle avulsion fracture following preexisting Osgood-Schlatter disease in an adolescent: a case report

Zhao,

Zhang,

Zhou

et al. 2024

J Int Med Res

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“…Because these fractures often occur due to immature subchondral bone, children between the ages of eight and fourteen are at high risk [ 8 ]. This injury is usually caused by a sudden contraction of the quadriceps muscle that puts significant strain on the patellar tendon, explaining the propensity of this injury for children who also play competitive or contact sports [ 9 ]. Tibial eminence fractures make up 2–5% of knee injuries in the pediatric population and 14% of ACL injuries in that demographic - leading to an overall prevalence of three per 100,000 children per year [ 2 , 3 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

Tibial Eminence Fracture and Pediatric ACL Avulsion Diagnosis and Treatment: A Case Report

Kosco,

Montalbano,

Scarano

et al. 2024

jocr

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Introduction: Tibial eminence fractures resulting from the avulsion of the anterior cruciate ligament (ACL) insertion are a common knee injury in the pediatric population. This injury is traditionally corrected through internal fixation using a guide pin and a cannulated screw. Due to the reported consequences of cannulated screws impinging on the joint space, we explored an alternative procedure to address this injury without the use of cannulated screws. We believe this is the first report of an alternate and improved procedure for repairing a tibial eminence fracture caused by ACL avulsion using non-absorbable sutures to secure the bony fragment back onto the tibial eminence. Case Report: We report the diagnosis, treatment, and follow-up of a 15-year-old Caucasian male who suffered a tibial eminence fracture associated with an ACL avulsion following a tackle football injury. We utilized a new all-arthroscopic procedure that involved securing the bony fragment of the tibial eminence using sutures that were passed through the ACL and proximal tibial using interosseous bone tunnels. Conclusion: This novel procedure successfully eliminates the need for intra-articular screws in the adolescent knee while treating tibial avulsion fractures - as supported by the patient’s marked radiographical and symptomatic improvement at the 2, 6, and 12-week follow-up visits. Keywords: Anterior cruciate ligament, tibial eminence, pediatrics.

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“… 2 20) Therefore, a sudden and forceful quadriceps contraction can cause violent tensile forces on the patella tendon, which overcomes physeal strength. 2 21) …”

Section: Discussionmentioning

confidence: 99%

Ogden Type IV Tibial Tuberosity Fractures in Healthy Adolescents: Preoperative Magnetic Resonance Imaging and 2-Year Clinical Follow-up Study

et al. 2023

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Background Ogden type IV tibial tuberosity fractures, defined as a type of fracture with posterior–inferior metaphyseal extension (Salter-Harris type II variant), are uncommon but challenging pediatric fractures. The purpose of this study was to investigate the clinical and radiological presentation and associated surgical outcomes. Methods Ten previously healthy patients who had been surgically treated at the authors’ institution between 2015 and 2018 with at least 2 years of postoperative follow-up were included. Demographic, clinical, and radiological characteristics and treatment/follow-up data were investigated. Results All included patients were male. All injuries resulted from jump-landings. Unacceptable remaining angular deformity after closed reduction, particularly increased posterior tibial slope angle, was the leading cause of surgery. All preoperative magnetic resonance images (MRIs) showed entrapped periosteum on the anteromedial side of the proximal tibial physis. Surgical removal of the entrapped periosteum achieved successful reduction. Metaphyseal fracture angles between the fracture plane of the metaphyseal beak and the posterior tibial condyle on the axial image of MRI were relatively constant, with an average of 24.3° ± 6.0°. Mean bone age at the time of trauma was older than mean chronological age (16.4 ± 1.0 years vs. 14.6 ± 1.1 years, respectively; p = 0.005). All patients reached skeletal maturity within 2 postoperative years, with little posttraumatic residual height growth (mean, 1.6 ± 0.7 cm from injury to skeletal maturity). At final follow-up, no patients showed significant angular deformity, tibial length discrepancy, or functional deficit. Conclusions In healthy adolescents, Ogden type IV tibial tuberosity fractures typically occur by jump-landing injuries, when they have little residual growth remaining. Therefore, accurate fracture reduction was required because of limited remodeling potential. Patients with unacceptable reduction should be investigated for entrapped periosteum on the anteromedial side of the physis because it was the primary obstacle in achieving adequate reduction.

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

Cited by 3 publications

References 19 publications

Tibial tubercle avulsion fracture following preexisting Osgood-Schlatter disease in an adolescent: a case report

Tibial tubercle avulsion fracture following preexisting Osgood-Schlatter disease in an adolescent: a case report

Tibial Eminence Fracture and Pediatric ACL Avulsion Diagnosis and Treatment: A Case Report

Ogden Type IV Tibial Tuberosity Fractures in Healthy Adolescents: Preoperative Magnetic Resonance Imaging and 2-Year Clinical Follow-up Study

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