Osteogenesis Imperfecta Presenting as Simultaneous Bilateral Tibial Tubercle Avulsion Fractures in a Child

Abstract

This is a case report of a unique presentation of a mild form of osteogenesis imperfecta (OI) (type IA) in a 9-year-old African-American boy who presented with simultaneous bilateral tibial tubercle avulsion fractures. The boy presented to the authors' emergency room complaining of acute bilateral knee pain. He could not perform a straight leg raise. Other than his orthopaedic examination, significant findings included blue sclera and irregular teeth. Radiographs and magnetic resonance imaging (MRI) confirmed bilateral tibia tubercle avulsion fractures. The patient underwent open reduction and internal fixation of his fractures, and postoperative genetic testing confirmed that the patient was heterozygous for OI. The authors present the fourth reported case of simultaneous bilateral tibial tubercle fractures. To their knowledge this is the first case of OI presenting with these fractures, the youngest reported case, and the first case with MRI documentation.

Acute simultaneous bilateral avulsion fractures of the tibial tubercles in a 15-year-old male hurler: case report and literature review

“…The first official report of simultaneous bilateral avulsion fractures of the tibial tubercles in a 15-year-old boy was described in 2003 [2]. Two further cases of these fractures occurring in patients with this condition have been reported [6,7].…”

Osteochondritis dissecans and Osgood Schlatter disease in a family with Stickler syndrome

“…The condition is caused by multiple submaximal avulsion fractures of the patellar tendon attachment to the tibial tubercle, when the tibial tubercle is in the apophyseal stage and the secondary ossification center has appeared. The aetiology of (OSS) also remains controversial [ 12 , 13 , 16 , 17 , 35 ].…”

Tibial Tuberosity Fracture in an Elderly Gentleman: An Unusual Injury Pattern

“…It may occur acutely or in the presence of long standing apophysitis. Causative factors suggested include tight hamstrings, pre-existing Osgood-Schlatter disease, and disorders involving physeal abnormalities [2,[17][18][19], and reports of such fracture are also seen in children with osteogenesis imperfect [20]. Though an association with the Osgood-Schlatter disease has been proposed, no causal relationship has been found as suggested by Ogden and Southwick [21].…”