Skip to main content Skip to main navigation menu Skip to site footer

Successful conservative treatment for Ogden type-IV tibial tubercle avulsion fracture with transverse fibular fracture in 15 years old boy in remote area: a case report

Abstract

Background: Tibial tubercle avulsion fracture is very rare. Its incidence has been reported to account for only 3% of all proximal tibia fractures and less than 1% of all growth plate injuries. This fracture occurs when the quadriceps are forcefully contracted against resistance, such as during jumping, or when rapid knee flexion occurs with contracted quadriceps, such as during landing. Most authors recommended surgical options in type IV tibial tubercle avulsion; however, we reported successful conservative treatment in this case report.

Case report: A 15-year-old male athlete with no significant past medical history presented via emergency medical services after a ground-level fall while playing basketball which landed with his left foot in a pivot position. He felt immediate pain and swelling about the left knee, all sensation was intact, as were pedal pulses, and neurovascularly remained intact. The patient did not want to go for medical evacuation to do surgery and consent to be managed with conservative treatment with close follow-up.

Conclusion: The results and prognosis of these fractures are excellent, despite the fracture pattern or treatment used, as long as an anatomical reduction is obtained

References

  1. Schiller J, DeFroda S, Blood T. Lower Extremity Avulsion Fractures in the Pediatric and Adolescent Athlete. J Am Acad Orthop Surg. 2017;25(4):251–9. Available from: http://dx.doi.org/10.5435/jaaos-d-15-00328
  2. Rogers WA. Fractures and Joint Injuries, Vol. 2, Ed. 4. Sir Reginald Watson-Jones, B.Sc., M.Ch.Orth., F.R.C.S., F.R.A.C.S. (Hon.), F.A.C.S. (Hon.). Edinburgh, E. & S. Livingstone, Ltd.; Baltimore, The Williams and Wilkins Company, 1955. $22.50 (two volumes). J Bone & Jt Surg. 1955;37(6):1326. Available from: http://dx.doi.org/10.2106/00004623-195537060-00030
  3. Checa Betegón P, Arvinius C, Cabadas González MI, Martínez García A, Del Pozo Martín R, Marco Martínez F. Management of pediatric tibial tubercle fractures: Is surgical treatment really necessary? Eur J Orthop Surg & Traumatol. 2019;29(5):1073–9. Available from: http://dx.doi.org/10.1007/s00590-019-02390-x
  4. RVU RKN, DEBENHAM JO. An Unusual Avulsion Fracture of the Proximal Tibial Epiphysis. Clin Orthop Relat Res. 1985;194(NA;):181???184. Available from: http://dx.doi.org/10.1097/00003086-198504000-00026
  5. Mosier SM, Stanitski CL. Acute Tibial Tubercle Avulsion Fractures. J Pediatr Orthop. 2004;24(2):181–4. Available from: http://dx.doi.org/10.1097/01241398-200403000-00009
  6. Pace JL, McCulloch PC, Momoh EO, Nasreddine AY, Kocher MS. Operatively Treated Type IV Tibial Tubercle Apophyseal Fractures. J Pediatr Orthop. 2013;33(8):791–6. Available from: http://dx.doi.org/10.1097/bpo.0b013e3182968984
  7. Khoriati A-A, Guo S, Thakrar R, Deol RS, Shah KY. Bilateral atraumatic tibial tubercle avulsion fractures: Case report and review of the literature. Injury. 2015;46(4):767–9. Available from: http://dx.doi.org/10.1016/j.injury.2015.01.012
  8. Pretell-Mazzini J, Kelly DM, Sawyer JR, Esteban EMA, Spence DD, Warner WC, et al. Outcomes and Complications of Tibial Tubercle Fractures in Pediatric Patients: A Systematic Review of the Literature. J Pediatr Orthop. 2016;36(5):440–6. Available from: http://dx.doi.org/10.1097/bpo.0000000000000488
  9. Wiss DA, Schilz JL, Zionts L. Type III Fractures of the Tibial Tubercle in Adolescents. J Orthop Trauma. 1991;5(4):475–9. Available from: http://dx.doi.org/10.1097/00005131-199112000-00015
  10. Mubarak SJ, Kim JR, Edmonds EW, Pring ME, Bastrom TP. Classification of proximal tibial fractures in children. J Child Orthop. 2009/03/17. 2009;3(3):191–7. Available from: https://pubmed.ncbi.nlm.nih.gov/19308478
  11. Brey JM, Conoley J, Canale ST, Beaty JH, Warner WC, Kelly DM, et al. Tibial Tuberosity Fractures in Adolescents. J Pediatr Orthop. 2012;32(6):561–6. Available from: http://dx.doi.org/10.1097/bpo.0b013e318263a370
  12. Medvecky M, Noonan B. Fractures About the Knee in Children and Adolescents. Tech Orthop. 2009;24(3):204–10. Available from: http://dx.doi.org/10.1097/bto.0b013e3181b58ed4

How to Cite

Michael Sutandio. (2022). Successful conservative treatment for Ogden type-IV tibial tubercle avulsion fracture with transverse fibular fracture in 15 years old boy in remote area: a case report. Bali Medical Journal, 11(3), 1426–1429. https://doi.org/10.15562/bmj.v11i3.3550

HTML
0

Total
0

Share

Search Panel

Michael Sutandio
Google Scholar
Pubmed
BMJ Journal