J Korean Fract Soc.  2010 Jul;23(3):317-320. 10.12671/jkfs.2010.23.3.317.

Operative Treatment of Bilateral Tibial Tuberosity Fractures in Adolescent: A Case Report

• Kim HK
• Yoo JH
• Park YW
• Park JS
• Noh KC
• Chung KJ
• Jang KJ
• Hwang JH

• KMID: 1712348
• DOI: http://doi.org/10.12671/jkfs.2010.23.3.317

Abstract

Bilateral avulsion fractures of the tibial tubercles are extremely rare. There is no case report about this in Korean literature. We present simultaneous bilateral tibial tuberosity fractures in 14-year-old adolescent male fell on the ground during running. These fractures were managed by open reduction and screw fixation. We gained complete union and removed metal after 6 months. Functional results were excellent 6 month after surgical treatment.

Keyword

Tibial tuberosity fractures; Bilateral; Adolescent

MeSH Terms

Adolescent
Humans
Male
Running

Figure

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  Figure 1 (A) (Rt): Fracture across the proximal tibial apophysis is completely displaced upward and rotated. (B) (Lt): Fracture line propagates upward across the primary proximal tibial epiphysis into the knee joint.

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  Figure 2 (A) (Rt) Avulsion fracture of the tibial tuberosity with infrapatellar tendon tear is definite in T1WI. (B) (Lt) Tibial tuberosity shows comminuted intraarticular fracture with avulsion. Fracture related bone and soft tissue edema is also seen, especially anteromedial asepct. Patella tendon reveals diffuse swelling with normal continuity.

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  Figure 3 Intraoperative photograph shows large communited avulsed fragment and ruptured retinaculum and thick periosteum in the left knee.

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  Figure 4 Completely union of previous avulsed fragments at 3 months after operations are seen in the plain AP and lateral view of both knees.

Reference

1. Ahmed D, Rangan R, Hagen J. Simultaneous bilateral tibial tuberosity avulsion-over 6-year follow-up. Eur J Trauma. 2006. 32:78–79.

2. Anja N, Oliver JM, Ulf B, Holger T. Bilateral avulsion fractures of the tibial tuberosity: A double case for open reduction and fixation. Eur J Trauma. 2008. 34:83–87.

3. Cyrus KK, Robert M, Micheal R, Norbert H. Simultaneous bilateral tibial tubercle avulsion fractures in a boy with osteogenesis imperfect. A case report and literature review. Eur J Trauma. 2003. 29:164–167.

4. Ergün M, Taşkiran E, Ozgürbüz C. Simultaneous bilateral tibial tubercle avulsion fracture in a basketball player. Knee Surg Sports Traumatol Arthrosc. 2003. 11:163–166.

5. Georgiou G, Dimitrakopoulou A, Siapkara A, Kazakos K, Provelengios S, Dounis E. Simultaneous bilateral tibial tubercle avulsion fracture in an adolescent: a case report and review of the literature. Knee Surg Sports Traumatol Arthrosc. 2007. 15:147–149.

6. Hamilton SW, Gibson PH. Simultaneous bilateral avulsion fractures of the tibial tuberosity in adolescence: a case report and review of over 50 years of literature. Knee. 2006. 13:404–407.

7. Hanley C, Roche SJ, Chhabra J. Acute simultaneous bilateral avulsion fractures of the tibial tubercles in a 15-year-old male hurler: case report and literature review. Ir J Med Sci. 2008. 12. 04. [Epub ahead of print].

8. Slobogean GP, Mulpuri K, Alvarez CM, Reilly CW. Comminuted simultaneous bilateral tibial tubercle avulsion fractures: a case report. J Orthop Surg (Hong Kong). 2006. 14:319–321.

9. Tulic G, Sopta J, Bumbasirevic M, Todorovic A, Vucetic C. Simultaneous bilateral avulsion fracture of the tibial tubercle in adolescent: a case report. J Pediatr Orthop B. 2010. 19:118–121.

10. Yoon JR, Kim TS, Kim HJ, Noh HK, Oh JK, Yoo JC. Simultaneous patellar tendon avulsion fracture from both patella and tibial tuberosity: a case report. Knee Surg Sports Traumatol Arthrosc. 2007. 15:225–227.