scholarly journals Tibial Tubercle Avulsion Fractures in Adolescents: A Narrative Review & Case Report

2021 ◽  
Vol 2 (3) ◽  
pp. 12-18
Author(s):  
Gregory W. Kunis ◽  
Joshua A. Berko ◽  
Jeffrey C. Shogan ◽  
Joshua B. Sharan ◽  
Derek Jones
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Avulsion Fracture ◽  
Open Reduction Internal Fixation ◽  
Fracture Pattern ◽  
Tibial Tuberosity ◽  
Tibial Tubercle ◽  
Significant Past Medical History ◽  
Anterior Portion ◽  
Avulsion Fractures

Intro: Tibial tuberosity avulsion fractures are rare fracture patterns accounting for less than 1% of all pediatric fractures. These fractures occur when there is a sudden unbalancing of forces through the patellar tendon that separates the tibial tubercle from the anterior portion of the proximal tibia. These forces are commonly introduced in sporting activities and show a predominance for adolescent males. Treatment with open reduction internal fixation commonly results in favorable outcomes with minimal complications. In this presentation, we explore a case of a tibial tuberosity avulsion fracture and give an in-depth review of all aspects concerning this fracture pattern. Case Description: A 14-year-old male with no significant past medical history presented via emergency medical services after a ground level fall while playing basketball. Radiographs of the left knee and tibia revealed an Ogden Type III, distracted avulsion fracture of the tibial tuberosity with suprapatellar effusion. Surgical intervention was achieved through open reduction internal fixation of the left tibial tubercle. Discussion: Although a relatively rare fracture pattern, this case demonstrates a classic presentation and treatment of a tibial tuberosity avulsion fracture. This case serves as a reminder that despite the rarity of the injury, a clinician with an appropriate index of suspicion can accurately diagnose and treat this fracture and achieve positive outcomes in returning the patient to pre-injury activities. For those reasons, we provide a comprehensive overview of all aspects regarding this fracture pattern including the anatomy, embryology, mechanism of action, predisposing conditions, treatment considerations, complications and associated injuries.

scholarly journals Anterior tibial spine (ACL avulsion) fracture treated with open reduction and fixation with screw: surgical technique, functional and clinico-radiological outcomes

2019 ◽  
Vol 5 (2) ◽  
pp. 340
Author(s):  
Rajesh V. Chawda ◽  
Vijay J. Patel ◽  
Dhaval M. Ninama ◽  
Harsh N. Patel
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Avulsion Fracture ◽  
Open Reduction Internal Fixation ◽  
Tibial Spine ◽  
Anterior Tibial ◽  
Stable Osteosynthesis ◽  
Radiological Healing ◽  
Acl Avulsion

<p class="abstract"><strong>Background:</strong> The anterior tibial spine fracture occurs almost at a same frequency both in adolescents and in adults. These injuries are often overlooked at emergency room. Stable internal fixation requires to gain optimum function of ACL by securing its length and nascent tension. We treated anterior tibial spine (ACL avulsion) fracture patient with open reduction and screw fixation.</p><p class="abstract"><strong>Methods:</strong> Study of Ten patients of anterior tibial spine (ACL avulsion) fracture, with minimum of 06 months and maximum of 18 months follow up. Classification of anterior tibial spine (ACL avulsion) a fracture done by Meyer and Mckeever. All patients operated with open reduction and internal fixation with screw via medial parapatellar approach. Functional and clinical outcome measured with Lysholm knee score at final follow up.<strong></strong></p><p class="abstract"><strong>Results:</strong> We studied 10 patients with anterior tibial spine (ACL avulsion) fractrure where mean age of patient was 36.4 years. Mean radiological healing was 10.6 weeks in anterior tibial spine (ACL avulsion) fracture. We observed mean motion of knee 133 degree in anterior tibial spine (ACL avulsion) fracture. Mean Lysholm score at final follow up was 86.8.</p><p class="abstract"><strong>Conclusions:</strong> Open reduction for anterior tibial spine (ACL) fracture provides direct visualization with easy application of screws ultimately confers stable osteosynthesis enables to start early range of motion and further rehabilitation protocol. Open reduction internal fixation is comparative less technically demanding, less expansive and gives excellent to good results as compared to other techniques.</p><p class="abstract"> </p>

scholarly journals Surgical Fixation of Bilateral Simultaneous Avulsion Fractures of the Proximal Tibia in a 12-Year-Old with History of Conservatively Managed Unilateral Tibial Avulsion Fracture

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Christopher Newman ◽  
Dharsh Musiienko ◽  
Samuel Law
Keyword(s):  
Avulsion Fracture ◽  
Tensile Force ◽  
Fracture Pattern ◽  
Tibial Tuberosity ◽  
Avulsion Fractures ◽  
Tibial Epiphysis ◽  
First Case ◽  
History Of ◽  
Surgical Fixation ◽  
Specific Fracture

Fractures of the proximal tibial epiphysis are rare, representing less than 3% of all epiphyseal and 1% of all physeal injuries in adolescents. Bilateral injuries are extremely rare. The specific anatomical and histological features of the proximal tibial epiphysis make it vulnerable to a specific fracture pattern that occurs when the tensile force of the quadriceps is greater than the fibrocartilaginous tissue underlying the tibial tuberosity. We report the first case to our knowledge of a 12-year-old boy who sustained simultaneous bilateral tibial avulsion fractures on the background of a previous conservatively managed unilateral tibial tuberosity avulsion fracture. We report this case for its uniqueness and as an educational review of the anatomy, the mechanism of injury, and the development of classifying these fractures and discussion of the stages of the growing physis that determine the treatment approach.

Incidence of Loss of Reduction After Open Reduction Internal Fixation of Metacarpal Shaft Fractures

Hand ◽  
2021 ◽  
pp. 155894472110031
Author(s):  
Scott T. Allen ◽  
Olivia J. Wang ◽  
Lauren O. Erickson ◽  
Christina M. Ward
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Plate Fixation ◽  
Open Reduction Internal Fixation ◽  
Fracture Pattern ◽  
Patient Age ◽  
Metacarpal Fractures ◽  
Lag Screw ◽  
Loss Of Reduction ◽  
With Screws

Background This study compared the incidence of loss of reduction (LOR) between metacarpal fractures fixed with screws alone and those fixed with plates and screws. Secondary aims included identifying patient or fracture characteristics associated with increased risk of LOR. Methods We retrospectively reviewed 138 metacarpal fractures in 106 patients treated with open reduction internal fixation with screws (60 fractures) or plates and screws (78 fractures) with a mean radiographic follow-up of 50 days for evidence of LOR. We compared the incidence of LOR between the screw and plate groups using a χ2 test. We performed logistic regression analysis to determine whether patient age, sex, metacarpal location (index, long, ring, small), the presence of multiple metacarpal fractures, or fracture pattern were associated with increased incidence of LOR. Results Loss of reduction occurred in 19 (13.8%) of 138 fractures, with no statistically significant difference between lag screw (7 of 60, 11.6%) and plate fixation (12 of 78, 15.4%). Neither fracture pattern nor the presence of multiple metacarpal fractures was associated with an increased incidence of LOR, but patients experienced a 7% increase in the risk of LOR for each additional year of age. Loss of reduction occurred most frequently in index metacarpal fractures (4 of 12, 33%), although this did not reach statistical significance. Conclusions We found no difference in LOR incidence between lag screw fixation and plate fixation. The overall incidence of LOR was higher in this study than previously reported and increased with increasing patient age.

scholarly journals Evaluation of Factors Driving Cost Variation for Distal Humerus Open Reduction Internal Fixation

2020 ◽  
Author(s):  
Michelle Zeidan ◽  
Andrew R. Stephens ◽  
Chong Zhang ◽  
Angela P. Presson ◽  
Andrew R. Tyser ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Distal Humerus ◽  
Open Reduction Internal Fixation ◽  
Cost Variation

scholarly journals Comparison of Minimally Invasive Percutaneous Plate Osteosynthesis and Open Reduction Internal Fixation on Proximal Humeral Fracture in Elder Patients: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Wei Zhao ◽  
Yuhui Zhang ◽  
Dongni Johansson ◽  
Xingyu Chen ◽  
Fang Zheng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Minimally Invasive ◽  
Internal Fixation ◽  
Open Reduction ◽  
Proximal Humeral Fracture ◽  
Plate Osteosynthesis ◽  
Meta Analysis ◽  
Humeral Fracture ◽  
Open Reduction Internal Fixation ◽  
Elder Patients

Objective. The study aims to compare minimally invasive percutaneous plate osteosynthesis (MIPO) and open reduction internal fixation (ORIF) in the treatment of proximal humeral fracture in elder patients. Method. PubMed, Medline, EMbase, Ovid, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wangfang, and VIP Database for Chinese Technical Periodicals were searched to identify all relevant studies from inception to October 2016. Data were analyzed with Cochrane Collaboration’s Review Manage 5.2. Results. A total of 630 patients from 8 publications were included in the systematic review and meta-analysis. The pooled results showed that MIPO was superior to ORIF in the treatment of proximal humeral fracture in elder patients. It was reflected in reducing blood loss, operation time, postoperative pain, or fracture healing time of the surgery and in improving recovery of muscle strength. Concerning complications, no significant difference was seen between MIPO and ORIF. Conclusion. The MIPO was more suitable than ORIF for treating proximal humeral fracture in elder patients.

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