There were 19 patients with 20 tibial tuberosity fractures. We offer epidemiological insight to this injury and propose a treatment algorithm based on our experience with these injuries. Our study includes 19 adolescents with 20 tibial tuberosity fractures, the largest single series to date, and attempts to review fracture morphology, mechanism of injury, management including return to play and complications. We retrospectively reviewed all the tibial tuberosity fractures in adolescents (10–19 years) that were managed in our tertiary level 1 pediatric trauma center. Finally, a Type V was suggested by McKoy and Stanitski, also described by Curtis, which consists of a Type IIIB fracture with an associated Type IV fracture creating a ‘Y’ configuration. for fractures with associated patella ligament avulsions. Next, the addition of a type C was proposed by Frankl et al. Ryu and Debenham then suggested the addition of a Type IV which is a fracture of the tibial tuberosity that extends posteriorly along the proximal tibial physis creating an avulsion of the entire proximal epiphysis. to more accurately define specific fracture patterns and to establish treatment for different fracture types by including displacement and comminution. This classification was modified by Ogden et al. Type III was an avulsion which extended proximal to the physis into the knee. Type II extended across the physis but did not enter the knee joint. Type I was an avulsion of a small part of the tibial tubercle, distal to the proximal tibial physis. The original classification system was provided by Sir Reginald Watson-Jones which defined three types. Ĭlassification of tibial tubercle fractures has gone through an evolution. The majority of these injuries are incurred during athletic activity involving jumping, most commonly basketball, and are the result of one of two possible mechanisms of injury : (1) violent knee flexion against a tightly contracting quadriceps, as in landing from a jump or (2) violent quadriceps contraction against a fixed foot, as in jumping. Typically, these fractures present with marked displacement of the entire proximal apophysis, with or without intra-articular extension, and variable associated soft tissue injury. Avulsion fracture of the tibial tubercle is a relatively uncommon injury, with a reported incidence ranging from 0.4% to 2.7%, usually seen in adolescent males approaching skeletal maturity with well developed quadriceps musculature.
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