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Tibial Tubercle Fracture

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  • Proximal Tibia has 2 ossification centres.

    • primary ossification center (proximal tibial physis)

    • secondary ossification center (tibial tubercle physis or apophysis)

      • insertion of patellar tendon

    • Tibial tubercle the last to fuse, at risk in older children.

  • Most common in adolescent Boys

  • Age 12-15

  • 4% develop Compartment syndrome

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MECHANISM

  •  Jump or landing where Quadriceps contraction pulls off the tubercle as the knee flexes. (basketball)

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MANAGEMENT

  • Analgesia

  • Nondisplaced fractures:

    • Cast for 6 weeks with the knee extended.

    • Fracture Clinic

REFER ORTHO IF:

  • Open Fracture

  • Neurovascular injury

  • Severe swelling/compartment syndrome

  • Displaced fracture

  • Fracture extends through primary ossification centre

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