Anterior Tibial Tuberosity Refracture in an Adolescent After Surgical Treatment. Case Report and Literature Review
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Published:
Dec 26, 2024
Keywords:
Refracture, anterior tibial tuberosity, surgery, adolescent
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Abstract
Refracture of the anterior tibial tuberosity in adolescents is a rare complication, particularly following surgical treatment, and has been scarcely reported in the literature. We present the case of an adolescent who sustained an anterior tibial tuberosity fracture, underwent surgical treatment at our center, and experienced a refracture four months later while playing sports. The patient underwent a second surgical procedure, which yielded favorable results. Although refracture is an uncommon complication, it is essential to recognize its possibility and to be prepared to manage it effectively. Further studies are required to identify the risk factors that may contribute to its occurrence.
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How to Cite
Jiménez Nava, C., Mena Roson, A., & Plasencia Arriba, M. Ángel. (2024). Anterior Tibial Tuberosity Refracture in an Adolescent After Surgical Treatment. Case Report and Literature Review. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 89(6), 637-646. https://doi.org/10.15417/issn.1852-7434.2024.89.6.1938
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Section
Case Presentations
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References
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fractures in skeletally immature patients: an update. Eur J Orthop Surg Traumatol 2020;30(5):789-98.
https://doi.org/10.1007/s00590-020-02629-y
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Rev 2020;5(5):260-7. https://doi.org/10.1302/2058-5241.5.190026
4. Pedrazzini A, Maserati I, Cesaro G, Visigalli A, Casalini D, Bertoni N, et al. Tibial tubercle avulsion fracture during sport activities in adolescent: a case report. Acta Biomed 2022;92(S3):e2021571. https://doi.org/10.23750/abm.v92iS3.12580
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Ortop Mex 2012;26(2):121-4. PMID: 23323303
6. Beaty JH, Kumar A. Fractures about the knee in children. J Bone Joint Surg Am 1994;76:1870-80.
https://doi.org/10.2106/00004623-199412000-00016
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basketball players. Orthopedics 2012;35(8):692-6. https://doi.org/10.3928/01477447-20120725-07
8. Borch-Madsen P. On symmetrical bilateral fracture of the tuberositas tibiae and eminentia intercondyloidea. Acta Orthop Scand 1954;24(1-4):44-9. https://doi.org/10.3109/17453675408988551
9. McKoy BE, Stanitski CL. Acute tibial tubercle avulsion fractures. Orthop Clin North Am 2003;34(3):397-403.
https://doi.org/10.1016/s0030-5898(02)00061-5
10. Brey JM, Conoley J, Canale ST, Beaty JH, Warner WC Jr, Kelly DM, et al. Tibial tuberosity fractures in
adolescents: is a posterior metaphyseal fracture component a predictor of complications? J Pediatr Orthop
2012;32(6):561-6. https://doi.org/10.1097/BPO.0b013e318263a370
11. Mostofi SB. Fracture classifications in clinical practice. London: Springer-Verlag London; 2006.
12. Ogden JA, Tross RB, Murphy MJ. Fractures of the tibial tuberosity in adolescents. J Bone Joint Surg Am
1980;62(2):205-15. PMID: 7358751
13. Ryu RK, Debenham JO. An unusual avulsion fracture of the proximal tibial epiphysis. Case report and proposed addition to the Watson-Jones classification. Clin Orthop Relat Res 1985;(194):181-4. PMID: 3978913
14. Frey S, Hosalkar H, Cameron DB, Heath A, David Horn B, Ganley TJ. Tibial tuberosity fractures in adolescents. J
Child Orthop 2008;2(6):469-74. https://doi.org/10.1007/s11832-008-0131-z
15. Polakoff DR, Bucholz RW, Ogden JA. Tension band wiring of displaced tibial tuberosity fractures in adolescents. Clin Orthop Relat Res 1986;209(209):161-5. PMID: 3731588
16. Pretell-Mazzini J, Kelly DM, Sawyer JR, Esteban EMA, Spence DD, Warner WC, et al. Outcomes and complications of tibial tubercle fractures in pediatric patients: A systematic review of the literature: A systematic
review of the literature. J Pediatr Orthop 2016;36(5):440-6. https://doi.org/10.1097/BPO.0000000000000488
17. Abalo A, Akakpo-numado KG, Dossim A, Walla A, Gnassingbe K, Tekou AH. Avulsion fractures of the tibial
tubercle. J Orthop Surg (Hong Kong) 2008;16(3):308-11. https://doi.org/10.1177/230949900801600308
18. Little RM, Milewski MD. Physeal fractures about the knee. Curr Rev Musculoskelet Med 2016;9(4):478-86.
https://doi.org/10.1007/s12178-016-9370-7
19. Valenzuela ML, López Soto V, Molina IL. Cirugía de rescate en casos de desplazamiento secundario crónico
de la tuberosidad tibial anterior en la adolescencia: a propósito de un caso. Rev Soc Andal Traumatol Ortop 2018;35(1):49-53. Disponible en: http://www.revista.portalsato.es/index.php/Revista_SATO/article/view/61/pdf
20. Andrews KA, Gillette M, Shah RV, Mckean LA, Sanford CG. Type IV tibial tubercle fracture-Salter-Harris type II
variant. J Surg Case Rep 2019;2019(7):rjz209. https://doi.org/10.1093/jscr/rjz209
fractures in children and adolescents: a population-based study based on the Kids’ Fracture Tool. Acta Orthop
2022;93:826-30. https://doi.org/10.2340/17453674.2022.4879
2. Formiconi F, D’Amato RD, Voto A, Panuccio E, Memeo A. Outcomes of surgical treatment of the tibial tuberosity
fractures in skeletally immature patients: an update. Eur J Orthop Surg Traumatol 2020;30(5):789-98.
https://doi.org/10.1007/s00590-020-02629-y
3. Rodriguez I, Sepúlveda M, Birrer E, Tuca MJ. Fracture of the anterior tibial tuberosity in children. EFORT Open
Rev 2020;5(5):260-7. https://doi.org/10.1302/2058-5241.5.190026
4. Pedrazzini A, Maserati I, Cesaro G, Visigalli A, Casalini D, Bertoni N, et al. Tibial tubercle avulsion fracture during sport activities in adolescent: a case report. Acta Biomed 2022;92(S3):e2021571. https://doi.org/10.23750/abm.v92iS3.12580
5. Ares O, Seijas R, Casas-Duhrkop, Catala J. Fractura de la tuberosidad anterior de la tibia en el adolescente. Acta
Ortop Mex 2012;26(2):121-4. PMID: 23323303
6. Beaty JH, Kumar A. Fractures about the knee in children. J Bone Joint Surg Am 1994;76:1870-80.
https://doi.org/10.2106/00004623-199412000-00016
7. Jakoi A, Freidl M, Old A, Javandel M, Tom J, Realyvasquez J. Tibial tubercle avulsion fractures in adolescent
basketball players. Orthopedics 2012;35(8):692-6. https://doi.org/10.3928/01477447-20120725-07
8. Borch-Madsen P. On symmetrical bilateral fracture of the tuberositas tibiae and eminentia intercondyloidea. Acta Orthop Scand 1954;24(1-4):44-9. https://doi.org/10.3109/17453675408988551
9. McKoy BE, Stanitski CL. Acute tibial tubercle avulsion fractures. Orthop Clin North Am 2003;34(3):397-403.
https://doi.org/10.1016/s0030-5898(02)00061-5
10. Brey JM, Conoley J, Canale ST, Beaty JH, Warner WC Jr, Kelly DM, et al. Tibial tuberosity fractures in
adolescents: is a posterior metaphyseal fracture component a predictor of complications? J Pediatr Orthop
2012;32(6):561-6. https://doi.org/10.1097/BPO.0b013e318263a370
11. Mostofi SB. Fracture classifications in clinical practice. London: Springer-Verlag London; 2006.
12. Ogden JA, Tross RB, Murphy MJ. Fractures of the tibial tuberosity in adolescents. J Bone Joint Surg Am
1980;62(2):205-15. PMID: 7358751
13. Ryu RK, Debenham JO. An unusual avulsion fracture of the proximal tibial epiphysis. Case report and proposed addition to the Watson-Jones classification. Clin Orthop Relat Res 1985;(194):181-4. PMID: 3978913
14. Frey S, Hosalkar H, Cameron DB, Heath A, David Horn B, Ganley TJ. Tibial tuberosity fractures in adolescents. J
Child Orthop 2008;2(6):469-74. https://doi.org/10.1007/s11832-008-0131-z
15. Polakoff DR, Bucholz RW, Ogden JA. Tension band wiring of displaced tibial tuberosity fractures in adolescents. Clin Orthop Relat Res 1986;209(209):161-5. PMID: 3731588
16. Pretell-Mazzini J, Kelly DM, Sawyer JR, Esteban EMA, Spence DD, Warner WC, et al. Outcomes and complications of tibial tubercle fractures in pediatric patients: A systematic review of the literature: A systematic
review of the literature. J Pediatr Orthop 2016;36(5):440-6. https://doi.org/10.1097/BPO.0000000000000488
17. Abalo A, Akakpo-numado KG, Dossim A, Walla A, Gnassingbe K, Tekou AH. Avulsion fractures of the tibial
tubercle. J Orthop Surg (Hong Kong) 2008;16(3):308-11. https://doi.org/10.1177/230949900801600308
18. Little RM, Milewski MD. Physeal fractures about the knee. Curr Rev Musculoskelet Med 2016;9(4):478-86.
https://doi.org/10.1007/s12178-016-9370-7
19. Valenzuela ML, López Soto V, Molina IL. Cirugía de rescate en casos de desplazamiento secundario crónico
de la tuberosidad tibial anterior en la adolescencia: a propósito de un caso. Rev Soc Andal Traumatol Ortop 2018;35(1):49-53. Disponible en: http://www.revista.portalsato.es/index.php/Revista_SATO/article/view/61/pdf
20. Andrews KA, Gillette M, Shah RV, Mckean LA, Sanford CG. Type IV tibial tubercle fracture-Salter-Harris type II
variant. J Surg Case Rep 2019;2019(7):rjz209. https://doi.org/10.1093/jscr/rjz209