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Tibial Tubercle Avulsion
A. Carlson Merrow, Jr., MD, FAAP
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Tibial tuberosity fracture
            • Definitions

              • Tibial tubercle ossification center is site of distal patellar tendon attachment
              • During adolescence, substantial traction force may acutely avulse this ossification center from its underlying physis with varying degrees of physeal & bony extension into proximal tibia

            IMAGING

            • General Features

              • Imaging Recommendations

                DIFFERENTIAL DIAGNOSIS

                  PATHOLOGY

                  • General Features

                    • Staging, Grading, & Classification

                      CLINICAL ISSUES

                      • Presentation

                        • Demographics

                          • Natural History & Prognosis

                            • Treatment

                              Selected References

                              1. Pretell-Mazzini J et al: Outcomes and complications of tibial tubercle fractures in pediatric patients: a systematic review of the literature. J Pediatr Orthop. ePub, 2015
                              2. Merrow AC et al: Avulsion fractures of the pediatric knee. Pediatr Radiol. 44(11):1436-45; quiz 1433-6, 2014
                              3. Jakoi A et al: Tibial tubercle avulsion fractures in adolescent basketball players. Orthopedics. 35(8):692-6, 2012
                              4. Tulic G et al: Simultaneous bilateral avulsion fracture of the tibial tubercle in adolescent: a case report. J Pediatr Orthop B. 19(1):118-21, 2010
                              5. Dupuis CS et al: Injuries and conditions of the extensor mechanism of the pediatric knee. Radiographics. 29(3):877-86, 2009
                              6. Zrig M et al: Acute tibial tubercle avulsion fractures in the sporting adolescent. Arch Orthop Trauma Surg. 128(12):1437-42, 2008
                              7. Georgiou G et al: Simultaneous bilateral tibial tubercle avulsion fracture in an adolescent: a case report and review of the literature. Knee Surg Sports Traumatol Arthrosc. 15(2):147-9, 2007
                              8. Slobogean GP et al: Osteogenesis imperfecta presenting as simultaneous bilateral tibial tubercle avulsion fractures in a child. J Pediatr Orthop. 25(3):411; author reply 411, 2005
                              9. Mosier SM et al: Acute tibial tubercle avulsion fractures. J Pediatr Orthop. 24(2):181-4, 2004
                              10. McKoy BE et al: Acute tibial tubercle avulsion fractures. Orthop Clin North Am. 34(3):397-403, 2003
                              Related Anatomy
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                              Related Differential Diagnoses
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                              References
                              Tables

                              Tables

                              KEY FACTS

                              • Terminology

                                • Imaging

                                  • Top Differential Diagnoses

                                    • Pathology

                                      • Clinical Issues

                                        TERMINOLOGY

                                        • Synonyms

                                          • Tibial tuberosity fracture
                                        • Definitions

                                          • Tibial tubercle ossification center is site of distal patellar tendon attachment
                                          • During adolescence, substantial traction force may acutely avulse this ossification center from its underlying physis with varying degrees of physeal & bony extension into proximal tibia

                                        IMAGING

                                        • General Features

                                          • Imaging Recommendations

                                            DIFFERENTIAL DIAGNOSIS

                                              PATHOLOGY

                                              • General Features

                                                • Staging, Grading, & Classification

                                                  CLINICAL ISSUES

                                                  • Presentation

                                                    • Demographics

                                                      • Natural History & Prognosis

                                                        • Treatment

                                                          Selected References

                                                          1. Pretell-Mazzini J et al: Outcomes and complications of tibial tubercle fractures in pediatric patients: a systematic review of the literature. J Pediatr Orthop. ePub, 2015
                                                          2. Merrow AC et al: Avulsion fractures of the pediatric knee. Pediatr Radiol. 44(11):1436-45; quiz 1433-6, 2014
                                                          3. Jakoi A et al: Tibial tubercle avulsion fractures in adolescent basketball players. Orthopedics. 35(8):692-6, 2012
                                                          4. Tulic G et al: Simultaneous bilateral avulsion fracture of the tibial tubercle in adolescent: a case report. J Pediatr Orthop B. 19(1):118-21, 2010
                                                          5. Dupuis CS et al: Injuries and conditions of the extensor mechanism of the pediatric knee. Radiographics. 29(3):877-86, 2009
                                                          6. Zrig M et al: Acute tibial tubercle avulsion fractures in the sporting adolescent. Arch Orthop Trauma Surg. 128(12):1437-42, 2008
                                                          7. Georgiou G et al: Simultaneous bilateral tibial tubercle avulsion fracture in an adolescent: a case report and review of the literature. Knee Surg Sports Traumatol Arthrosc. 15(2):147-9, 2007
                                                          8. Slobogean GP et al: Osteogenesis imperfecta presenting as simultaneous bilateral tibial tubercle avulsion fractures in a child. J Pediatr Orthop. 25(3):411; author reply 411, 2005
                                                          9. Mosier SM et al: Acute tibial tubercle avulsion fractures. J Pediatr Orthop. 24(2):181-4, 2004
                                                          10. McKoy BE et al: Acute tibial tubercle avulsion fractures. Orthop Clin North Am. 34(3):397-403, 2003