Abstract

The patient was a 32-year-old male who sustained a noncontact left knee injury during a quick pivot on a planted left foot, while playing flag football.He felt a pop in his knee, noted immediate swelling, and was unable to bear weight. He subsequently presented to the emergency department for evaluation. Radiographs of the left knee revealed findings consistent with a tibial spine avulsion fracture, while magnetic resonance imaging confirmed a medial tibial spine avulsion fracture. Bone marrow edema was noted in a pivot shift injury pattern involving the lateral femoral condyle and the lateral tibial plateau, and there was also a fracture of the posterior lateral tibial cortex at the site of the bone marrow edema. To determine the best course of treatment, a computed tomography scan was ordered to better visualize the extent of the avulsion fracture. The computed tomography scan demonstrated a comminuted fracture through the tibial spine. J Orthop Sports Phys Ther 2010;40(9):595. doi:10.2519/jospt.2010.0414

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