Tibial Tubercle/Eminence Fracture Flashcards
What is the mechanism of a pediatric tibial tubercle fracture?
Active quadriceps extension with flexed knee (jumping or sprinting)
In displaced tibial tubercle fractures what vessel can be injured, increasing risk of compartment syndrome?
Recurrent anterior tibial artery
What is the classification of tibial tubercle fractures?
Ogden
Type I- fx of secondary ossification center at patellar tendon insertion
Type II- fx that propagates from secondary to primary ossification center
Type III- fx propagates through the primary ossification center
Type IV- fx propagates through the entire physis
Type V- periosteal avulsion from patellar tendon insertion
What is the treatment if tibial tubercle fractures in pediatric patients?
Displaced less than 2mm; long leg cast
Type 1, 2 and 4; CRPP vs ORIF
Type 3 need arthrotomy
Type 5 need soft tissue repair
Types 1-4 long leg cast for 4-6 weeks
Type 5 long leg cast for 8-10 weeks
What deformity is seen with pediatric tibial tubercle fractures?
Recurvatum
What injury is commonly a/w tibial eminence fracture?
meniscal tear
What is the classification of tibial eminence fractures?
Meyers and McKeever
Type I- non displaced
Type II- displaced with intact posterior hinge
Type III- completely displaced
What is the treatment of tibial eminence fractures?
1) Closed reduction, evacuation of hemarthrosis and immobilization in 0-20° of extension for Type I and reducible Type II fractures
2) Arthroscopic vs ORIF for unreducible Type II and III fractures
What are the pros and cons of fixation options for tibial eminence fractures?
Suture:
Avoids physeal injury; technically demanding
ORIF:
Earlier mobilization; physeal injury
What is the most common complication of tibial eminence fractures?
Arthrofibrosis; up to 25% require MUA
Pts can also have ACL laxity
non-op 20%
operative 10%
