Abstract
Fractures of the proximal epiphysis of the tibia are rare, representing 0.5 to 3.0% of all epiphyseal injuries. These injuries can damage the popliteal vessels and their bifurcation, affecting the blood supply of the lower limb, as well as the nerves below the knee. Epiphyseal growth arrest is also a potential complication, leading to various angular deformities. We present a case of a 13-year-old male athlete with a posteriorly displaced Salter-Harris type II fracture of the proximal epiphysis of the left tibia who was treated conservatively with closed reduction and cast immobilization.
Highlights
Tibial tuberosity avulsion fractures are rare. This rarity is due to the anatomy of the collateral ligaments which are inserted distally into the metaphysis protecting the epiphysis
This injury can threaten the limb circulation, secondary to vascular compromise or compartment syndrome, and it should be treated as an urgent situation
Ogden et al [5] described three types of tibial tuberosity avulsion fractures: type I, where small fragment is displaced upwards, type II, where entire tongue formed by the tibial tuberosity is hinged upwards, and type III, where the line of fracture passes upwards and backwards across the proximal articular surface of the tibia
Summary
This rarity is due to the anatomy of the collateral ligaments which are inserted distally into the metaphysis protecting the epiphysis. This injury can threaten the limb circulation, secondary to vascular compromise or compartment syndrome, and it should be treated as an urgent situation. The goal of treatment is anatomical reduction and stabilisation in order to prevent significant soft tissue injury, malunion, and growth arrest [1]
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