Tibial tubercle avulsion fracture during sport activities in adolescent: a case report

Tibial tubercle avulsion fracture during sport activities in adolescent: a case report

Authors

  • Alessio Pedrazzini Orthopaedic Unit, Oglio Po Hospital, Vicomoscano (CR), ASST Cremona, Italy
  • Ilaria Maserati Orthopaedic and Traumatology Clinic, Department of Medicine and Surgery, University of Parma, Parma, Italy
  • Giuseppe Cesaro Orthopaedic and Traumatology Clinic, Department of Medicine and Surgery, University of Parma, Parma, Italy
  • Alberto Visigalli Orthopaedic and Traumatology Clinic, Department of Medicine and Surgery, University of Parma, Parma, Italy
  • Daniele Casalini Orthopaedic Unit, Oglio Po Hospital, Vicomoscano (CR), ASST Cremona, Italy;
  • Nicola Bertoni Orthopaedic Unit, Oglio Po Hospital, Vicomoscano (CR), ASST Cremona, Italy;
  • Simon Henry Yewo Orthopaedic Unit, Oglio Po Hospital, Vicomoscano (CR), ASST Cremona, Italy
  • Francesco Pogliacomi Orthopaedic and Traumatology Clinic, Department of Medicine and Surgery, University of Parma, Parma, Italy

Keywords:

Adolescent, tibial tubercle avulsion, synthesis, patellar retinaculum, childhood.

Abstract

Background and aim of work: Tibial tubercle avulsion fractures (TTAF) are uncommon condition in children and adolescents. These lesions may be misdiagnosed and consequently not properly treated. Reduction and fixation is indicated if displacement is higher than 2mm or if the extensor apparatus is damaged. Authors present a case of a TTAF associated with a complete lateral patellar retinaculum lesion in a 13-year-old male adolescent non-professional basketball player. Methods: Surgery consisted of reduction and fixation with 2 half threaded cancellous and washers; TTA was then basted and reinforced with a non absorbable suture according to Krachow technique and finally the patellar lateral retinaculum through a direct repair with absorbable material. Results: Clinical evaluation after 3 years showed bone healing, a complete resolution of pain, complete range of motion, good strength and complete functionality of the operated limb. Conclusions: Misdiagnosis or delayed treatment of TTAF can often result in nonunion, functional impairment, and persistent pain. For these reasons, authors believe that a stable and quick fixation associated to specialized rehabilitation are crucial for recovery. (www.actabiomedica.it)

References

Zaizi A; El Yaacoubi T; Chafry B; Boussouga M. Tibial tubercle avulsion fractures in school sports injury: A case report. International Journal of Surgery Case Reports, 2019, 58(), 30–32.

Cole WW.; Brown SM.; Vopat B; Heard WMR.; Mulcahey MK. Epidemiology, Diagnosis, and Management of Tibial Tubercle Avulsion Fractures in Adolescents. JBJS Reviews, 2020, 8(4), e0186–.

Arkader A; Schur M; Refakis C; Capraro A; Woon R; Choi P. Unicortical Fixation is Sufficient for Surgical Treatment of Tibial Tubercle Avulsion Fractures in Children. Journal of Pediatric Orthopaedics, 2019, 39(1), e18–e22.

Shin YW; Kim DW; Park KB. Tibial tubercle avulsion fracture according to different mechanisms of injury in adolescents. Medicine, 2019, 98(32), e16700–.

Franz P; Luderowski E; Tuca M. Tibial tubercle avulsion fractures in children. Current Opinion in Pediatrics, 2020, 32(1), 86–92.

Makram Z; Hedi A; Taoufik A; Mohsen T; Mondher M; Habib BH. Acute tibial tubercle avulsion fractures in the sporting adolescent, 2008, 128(12), 1437–1442.

McKoy BE, Stanitski CL. Acute tibial tubercle avulsion fractures. Orthop Clin North Am. 2003 Jul;34(3):397-403.

Mosier SM; Stanitski CL. Acute Tibial Tubercle Avulsion Fractures. Journal of Pediatric Orthopaedics 2004, 24(2), 181–184.

Ogden JA, Tross RB, Murphy MJ. Fractures of the tibial tuberosity in adolescents. J Bone Joint Surg Am. 1980 Mar;62(2):205-15.

Mubarak SJ; Kim JR; Edmonds EW; Pring ME; Bastrom TP. Classification of proximal tibial fractures in children 2009, 3(3), 191–197.

Pretell-Mazzini J; Kelly DM.; Sawyer JR. et al. Journal of Pediatric Orthopaedics 2016, 36(5), 440–446.

Kushner RL, Massey P. Tibial Tubercle Avulsion. 2021 Jun 5. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing

Checa Betegón, P.; Arvinius, C.; Cabadas González, M. I.; Martínez García, A.; Del Pozo Martín, R.; Marco Martínez, F. Management of pediatric tibial tubercle fractures: Is surgical treatment really necessary?. European Journal of Orthopaedic Surgery & Traumatology 2019.

Abalo A, Akakpo-numado KG, Dossim A, Walla A, Gnassingbe K, Tekou AH. Avulsion fractures of the tibial tubercle. J Orthop Surg (Hong Kong). 2008 Dec;16(3):308-11.

Yue I; Hurst N; Peterson JB; Kanegaye JT; Auten JD. Bilateral tibial tubercle avulsion fractures: A pediatric orthopedic injury at high risk for compartment syndrome. The American Journal of Emergency Medicine 2019, S0735675719303444–.

Pape JM, Goulet JA, Hensinger RN. Compartment syndrome complicating tibial tubercle avulsion. Clin Orthop Relat Res. 1993 Oct;(295):201-4.

Brey JM, Conoley J, Canale ST et al. Tibial tuberosity fractures in adolescents: is a posterior metaphyseal fracture component a predictor of complications? J Pediatr Orthop. 2012 Sep;32(6):561-6.

Rodriguez I, Sepúlveda M, Birrer E, Tuca MJ. Fracture of the anterior tibial tuberosity in children. EFORT Open Rev. 2020 May 5;5(5):260-267.

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Published

10-03-2022

How to Cite

1.
Pedrazzini A, Maserati I, Cesaro G, Visigalli A, Casalini D, Bertoni N, et al. Tibial tubercle avulsion fracture during sport activities in adolescent: a case report. Acta Biomed [Internet]. 2022 Mar. 10 [cited 2024 Jul. 25];92(S3):e2021571. Available from: https://www.mattioli1885journals.com/index.php/actabiomedica/article/view/12580