Acta Scientific Orthopaedics (ISSN: 2581-8635)

Case Report Volume 3 Issue 12

Bilateral Tibial Tubercle Fracture in Adolescence: A Case Report and Review of the Literature

Panagiotis Poulios1*, Athanasios Serlis1, Livio Di Mascio2, Adrian Carlos2, Alexandros Vris2 and Georgios Konstantopoulos2

1Newham University Hospital, Orthopaedic Department, United Kingdom
2Royal London Hospital, Orthopaedic Department, United Kingdom

*Corresponding Author: Panagiotis Poulios, Newham University Hospital, Orthopaedic Department, United Kingdom.

Received: November 13, 2020; Published: November 27, 2020

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Abstract

Background: Fractures of the tibial tubercle are relatively uncommon injuries. Bilateral tibial tubercle fractures are substantially rare; particularly the high-grade patterns. These types of fractures occasionally involve the growth plate, extend through the articular surface and have a reasonable good prognosis despite their bilateral nature. The available literature body is supporting the surgical fixation of these injuries, while there are no reports for conservative management. In this manuscript, we report satisfactory outcomes with conservative management and close follow-up.

Case Summary: In this article, we report an Ogden type IVA simultaneous bilateral tibial tubercle fractures in a 12-year-old boy after a reported ground-level fall during sporting activity. These injuries were managed conservatively with close follow-up and repeat imaging. Clinical and radiological results were excellent at the final review.

Conclusion: The bilateral tibial tubercle fractures are a rare injury in the paediatric population. The majority of the reported cases in the literature support surgical fixation as the choice of treatment. In this case, we report satisfactory outcomes with conservative management and close follow-up, and we review the relevant literature.

Keywords: Bilateral; Tibial Tubercle; Fracture; Conservative; Paediatric; Case Report

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References

  1. Pretell-Mazzini J., et al. “Outcomes and Complications of Tibial Tubercle Fractures in Pediatric Patients”. Journal of Pediatric Orthopaedics5 (2016): 440-446.
  2. Riccio AI., et al. “Functional Outcomes Following Operative Treatment of Tibial Tubercle Fractures”. Journal of Pediatric Orthopaedics2 (2019): e108-e113.
  3. Ergün M., et al. “Simultaneous bilateral tibial tubercle avulsion fracture in a basketball player”. Knee Surgery, Sports Traumatology, Arthroscopy3 (2003): 163-166.
  4. Pandya NK., et al. “Tibial Tubercle Fractures”. Journal of Pediatric Orthopaedics8 (2012): 749-759.
  5. Pace JL., et al. “Operatively Treated Type IV Tibial Tubercle Apophyseal Fractures”. Journal of Pediatric Orthopaedics8 (2013): 791-796.
  6. Hamilton SW and Gibson PH. “Simultaneous bilateral avulsion fractures of the tibial tuberosity in adolescence: a case report and review of over 50 years of literature”. The Knee5 (2006): 404-407.
  7. Mosier SM and Stanitski CL. “Acute Tibial Tubercle Avulsion Fractures”. Journal of Pediatric Orthopaedics2 (2004): 181-184.
  8. Watson-Jones R and Wilson JN. “Fractures and Joint Injuries”. Edinburgh [U.A.] Churchill Livingstone (1976).
  9. Alter AH. “Fracture of the tibial tubercle”. Journal of Pediatric Surgery4 (1977): 626.
  10. Mubarak SJ., et al. “Classification of proximal tibial fractures in children”. Journal of Children’s Orthopaedics3 (2009): 191-197.
  11. Pape JM., et al. “Compartment Syndrome Complicating Tibial Tubercle Avulsion”. Clinical Orthopaedics and Related Research 295 (1993): 201-204.
  12. Polakoff DR., et al. “Tension Band Wiring of Displaced Tibial Tuberosity Fractures in Adolescents”. Clinical Orthopaedics and Related Research NA 209 (1986): 161-165.
  13. Wiss DA., et al. “Type III Fractures of the Tibial Tubercle in Adolescents”. Journal of Orthopaedic Trauma 4 (1991): 475-479.
  14. Christie MJ and Dvonch VM. “Tibial Tuberosity Avulsion Fracture in Adolescents”. Journal of Pediatric Orthopaedics4 (1981): 391-394.
  15. Ogden JA., et al. “Fractures of the tibial tuberosity in adolescents”. The Journal of Bone and Joint Surgery2 (1980): 205-215.
  16. Ryu RKN and Debenham JO. “An unusual avulsion fracture of the proximal tibial epihysis.”. Journal of Pediatric Orthopaedics5 (1985): 630.
  17. Frankl U., et al. “Avulsion fracture of the tibial tubercle with avulsion of the patellar ligament. Report of two cases”. The Journal of Bone and Joint Surgery9 (1990): 1411-1413.
  18. Blanks RH., et al. “Flexion-Type Salter I1 Fracture of the Proximal Tibia Proposed Mechanism of Injury and Two Case Studies”. Clinical Orthopaedics and Related Research 301 (1994): 256???259.
  19. Shapiro F. “Pediatric Orthopedic Deformities: Basic Science, Diagnosis and Treatment”. Apuk (2002).
  20. Dvonch VM and Bunch WH. “Pattern of Closure of the Proximal Femoral and Tibial Epiphyses in Man”. Journal of Pediatric Orthopaedics4 (1983): 498-501.
  21. Todd TW. “The Anatomical Features of Epiphysial Union”. Child Development3 (1930): 186.
  22. Wilson NHF and Gardner DL. “The microscopic structure of fibrous articular surfaces: A review”. The Anatomical Record2 (1984): 143-152.
  23. Ogden JA and Southwick WO. “Osgood-Schlatter??s Disease and Tibial Tuberosity Development”. Clinical Orthopaedics and Related Research NA 116 (1976): 180-189.
  24. Ahn JH., et al. “Clinical Experience of the Tibial Plateau Fracture”. Journal of the Korean Orthopaedic Association3 (1990): 684.
  25. Chan PSH., et al. “Impact of CT Scan on Treatment Plan and Fracture Classification of Tibial Plateau Fractures”. Journal of Orthopaedic Trauma7 (1997): 484-489.
  26. Yacoubian SV., et al. “Impact of MRI on Treatment Plan and Fracture Classification of Tibial Plateau Fractures”. Journal of Orthopaedic Trauma 9 (2002): 632-637.
  27. Falciglia F., et al. “Osgood Schlatter Lesion: Histologic Features of Slipped Anterior Tibial Tubercle”. International Journal of Immunopathology and Pharmacology 24 (2011): 25-28.
  28. Gurbuz K. “Avulsion Fracture of the Tibial Tubercle Associated with Patellar Ligament Avulsion in a Sporting Adolescent: A Rare Case”. Journal of Clinical and Analytical Medicine4 (2014).
  29. Kramer DE., et al. “Tibial Tubercle Fragmentation: A Clue to Simultaneous Patellar Ligament Avulsion in Pediatric Tibial Tubercle Fractures”. Orthopedics 5 (2008): 1-4.
  30. Franz P., et al. “Tibial tubercle avulsion fractures in children”. Current Opinion in Pediatrics1 (2020): 86-92.
  31. Shin Y-W., et al. “Tibial tubercle avulsion fracture according to different mechanisms of injury in adolescents”. Medicine32 (2019): e16700.
  32. Subbu R., et al. “Lessons learnt from managing an avulsion fracture of the tibial tubercle extending into the tibial physis”. Case Reports 2013 (2013): bcr2013200551-bcr2013200551.
  33. Alter AH. “Compartment syndrome as a complication of the hauser procedure”. Journal of Pediatric Surgery 6 (1979): 866.
  34. Curtis JF. “Type IV Tibial Tubercle Fracture Revisited”. Clinical Orthopaedics and Related Research 389 (2001): 191-195.
  35. von Laer L. “Classification, diagnosis, and treatment of transitional fractures of the distal part of the tibia”. The Journal of Bone and Joint Surgery5 (1985): 687-698.
  36. Choi N-H and Kim N-M. “Case Report Tibial Tuberosity Avulsion Fracture Combined With Meniscal Tear”. Arthroscopy: The Journal of Arthroscopic and Related Surgery7 (1999): 766-769.
  37. Falster O and Hasselbalch H. “Avulsion fracture of the tibial tuberosity with combined ligament and meniscal tear”. The American Journal of Sports Medicine1 (1992): 82-83.
  38. Lipscomb AB., et al. “Fracture of the tibial tuberosity with associated ligamentous and meniscal tears. A case report”. The Journal of Bone and Joint Surgery5 (1984): 790-792.
  39. Hresko MT and Kasser JR. “Physeal arrest about the knee associated with non-physeal fractures in the lower extremity”. The Journal of Bone and Joint Surgery5 (1989): 698-703.
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Citation

Citation: Panagiotis Poulios., et al. “Bilateral Tibial Tubercle Fracture in Adolescence: A Case Report and Review of the Literature".Acta Scientific Orthopaedics 3.12 (2020): 75-82.




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