Bilateral Simultaneous Tibial Tubercle Avulsion in an Adolescent Football Player with Previous Bilateral Osgood–Schlatter Disease

Tibial tubercle avulsion fractures are a very uncommon injury, accounting between 0.4 and 2.7% of all epiphyseal injuries. Bilateral lesions are extremely rare with only 20 cases described in the literature. They occur more frequently in male adolescents and during sport activities that require jumping and sprinting, such as football or basketball. We report the case of a 13-year-old boy who sustained simultaneous bilateral tibial avulsion fractures on the background of a previous conservatively managed bilateral Osgood–Schlatter disease.

Proximal Tibial Epiphysis Fracture in a 13-Year-Old Male Athlete

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.

Peri-epiphyseal and Overuse Injuries in Adolescent Athletes

Context: Overuse injuries of the musculoskeletal system in immature athletes are commonly seen in medical practice. Evidence Acquisition: An analysis of published clinical, outcome, and biomechanical studies of adolescent epiphyseal and overuse injuries was performed through 2008 to increase recognition and provide treatment recommendations. Results: Adolescent athletes can sustain physeal and bony stress injuries. Recovery and return to play occur more swiftly if such injuries are diagnosed early and immobilized until the patient is pain-free, typically about 4 weeks for apophyseal and epiphyseal overuse injuries. Certain epiphyseal injuries have prolonged symptoms with delayed treatment, including those involving the bones in the hand, elbow, and foot. If such injuries are missed, prolonged healing and significant restrictions in athletic pursuits may occur. Conclusion: Some of these injuries are common to all weightbearing sports and are therefore widely recognized. Several are common in gymnastics but are rarely seen in other athletes. Early recognition and treatment of these conditions lead to quicker recovery and so may prevent season-ending, even career-ending, events from occurring.