Pediatric Tibial Tuberosity Fracture

synonyms:

Pediatric Tibial Tuberosity Fracture ICD-9

Pediatric Tibial Tuberosity Fracture Etiology / Epidemiology / Natural History

• Avulsion injury from forceful concentric contraction during a jump or an eccentric contraction during landing.

Pediatric Tibial Tuberosity Fracture Anatomy

• Portions of the tibial tubercle, unfused anterior tibial epiphysis and extensor retinaculum are avulsed from the anterior tibia/

Pediatric Tibial Tuberosity Fracture Clinical Evaluation

Pediatric Tibial Tuberosity Fracture Xray / Diagnositc Tests

• A/P and lateral views of the knee. Generally best seen on lateral view.
• CT: consider for fractures with intraarticular extention.

Pediatric Tibial Tuberosity Fracture Classification / Treatment

• Type I: small fragment proximally displaced.
  -Nondisplaced: Treatment = Long leg cast in extention.
  -Displaced: attempted closed reduction with gentle pressure. If displaced remains consider ORIF.
• Type II: fracture at the junction site of the secdary center of ossification and the proximal tibial epiphysis. Articular surface intact
  -Treatment: ORIF generally with 1-2 cannulated screws placed from anterior to posterior.
• Type III: fracture extends inot the articular surface.
  -Treatment: ORIF generally with 1-2 cannulated screws placed from anterior to posterior. Ensure articular surface is anatomically reduced.

Pediatric Tibial Tuberosity Fracture Associated Injuries / Differential Diagnosis

Pediatric Tibial Tuberosity Fracture Complications

• Compartment syndrome

Pediatric Tibial Tuberosity Fracture Follow-up Care

Pediatric Tibial Tuberosity Fracture Review References

• McKoy BE, Orthop Clin North Am 2003;34:397
• Zionts LE, JAAOS;10:345
• °