A Type IV Tibial Tuberosity Avulsion Fracture in an Adolescent - A Case Report

Tibial tuberosity avulsion fractures in adolescents are one of the rare physeal injuries. Sudden powerful contraction of quadriceps muscle leads to avulsion fractures and varying degrees of disruption of extensor mechanism.

A 16-year-old boy sustained tibial tuberosity avulsion fracture while playing football and presented with sudden onset of pain, massive swelling, and loss of active extension of the left knee along with inability to bear weight on the left leg. Due to imminent risk of development of compartment, patient was taken for surgical correction immediately. Open reduction and internal fixation were done using 02 × 4 mm partially threaded cannulated cancellous screws. Patient was immobilized with above knee cast and kept non-weight bearing for 6 weeks. Later, gradual weight bearing ambulation was allowed and ROM and strengthening of knee was carried out. Patient had regained complete ROM of knee and returned to sporting activities by end of 6 months.

Tibial tuberosity avulsion fractures are a rare occurrence and even rarer is them getting complicated by compartment syndrome. A high index of suspicion for development of compartment syndrome in an avulsion fracture of tibial tuberosity and a timely management can avert such potential complications and enables to achieve an optimal results.