BACKGROUND: Tibial tubercle fractures often occur in athletic adolescents close to skeletal maturity. These fractures can present with marked displacement of the apophysis, intra-articular extension, and associated soft tissue injuries, such as tibial meniscal ligament tears. Here, we present our surgical technique which focuses on recreating the meniscal-articular relationship (using suture anchors) in severely displaced fractures. METHODS: We retrospectively reviewed all tibial tuberosity fractures treated with this technique over the last 2.5 years. Fractures with a minimum of a 12-month follow-up post-fixation were identified. Clinical records and radiographs were reviewed. Data included patient age, gender, involved side, injury classification (modified Ogden), mechanism of injury, treatment, return to activity, and complications. RESULTS: Six patients met the inclusion criteria. Mean age at time of surgery was 14.9 (range 13.2-16.8) years. All patients were male and the mean follow-up period was 14 (12-26) months. Range of motion was started at 4 weeks post-operatively in a hinged knee brace, and return to sports occurred at an average of 3.75 months postoperatively (range 3-5 months). No evidence of growth disturbance of the proximal tibia or recurvatum at final follow-up was evident. CONCLUSION: We speculate that patients who sustain a tibial tubercle avulsion fracture types III or V will likely have intra-articular pathology, specifically capsular avulsion or coronary ligament disruption. By utilizing suture anchors, our technique emphasizes renewing the anatomic articular environment to ensure better long-term results and maintaining these active individuals in sports.
BACKGROUND: Tibial tubercle fractures often occur in athletic adolescents close to skeletal maturity. These fractures can present with marked displacement of the apophysis, intra-articular extension, and associated soft tissue injuries, such as tibial meniscal ligament tears. Here, we present our surgical technique which focuses on recreating the meniscal-articular relationship (using suture anchors) in severely displaced fractures. METHODS: We retrospectively reviewed all tibial tuberosity fractures treated with this technique over the last 2.5 years. Fractures with a minimum of a 12-month follow-up post-fixation were identified. Clinical records and radiographs were reviewed. Data included patient age, gender, involved side, injury classification (modified Ogden), mechanism of injury, treatment, return to activity, and complications. RESULTS: Six patients met the inclusion criteria. Mean age at time of surgery was 14.9 (range 13.2-16.8) years. All patients were male and the mean follow-up period was 14 (12-26) months. Range of motion was started at 4 weeks post-operatively in a hinged knee brace, and return to sports occurred at an average of 3.75 months postoperatively (range 3-5 months). No evidence of growth disturbance of the proximal tibia or recurvatum at final follow-up was evident. CONCLUSION: We speculate that patients who sustain a tibial tubercle avulsion fracture types III or V will likely have intra-articular pathology, specifically capsular avulsion or coronary ligament disruption. By utilizing suture anchors, our technique emphasizes renewing the anatomic articular environment to ensure better long-term results and maintaining these active individuals in sports.
Authors: Stephan V Yacoubian; Russell T Nevins; Julian G Sallis; Hollis G Potter; Dean G Lorich Journal: J Orthop Trauma Date: 2002-10 Impact factor: 2.512
Authors: Rodrigo Pires e Albuquerque; André Siqueira Campos; Gabriel Costa Serrão de Araújo; Vinícius Schott Gameiro Journal: BMJ Case Rep Date: 2013-11-29
Authors: P Checa Betegón; C Arvinius; M I Cabadas González; A Martínez García; R Del Pozo Martín; F Marco Martínez Journal: Eur J Orthop Surg Traumatol Date: 2019-02-06
Authors: Rodolfo Morales-Avalos; Luis E Martínez-Manautou; Santiago de la Garza-Castro; Alejandra J Pozos-Garza; Gregorio A Villarreal-Villareal; Víctor M Peña-Martínez; Félix Vílchez-Cavazos Journal: World J Orthop Date: 2020-12-18