Refers to partial avulsion of the tibia tuberosity, with no involvement of the tibial physis.Usually occurs in patients in late childhood or early adolescence. More common in boys, it may represent an over use disease. The repetiteve stress on tuberosity may cuse partial avulsion. If intervening gap fills with fibrous tissue rather than bone, a painful non union will develop. Secundary defective ossification will cause proeminence of the tubercle too.
• Local swelling and tenderness.
• Enlargement of the tibial tubercle.
• Pain is agravated by direct pressure and quadriceps contraction (jumping).
• Avulsion of the tibial tubercle - Osgood - Schlatter disease may be a risk for complete avulsion of the tibial tubercle.
Radiographs will not be helpful if injury occurs during preossification phase.Once ossification center develops, radiographs will reveal radiodense fragments separated from tibial tuberosity.
Treatment is symptomatic and conservative. Immobilization of the knee in an extension cylinder cast for 4 to 6 weeks may be helpful in particuculary symptomatic cases. Avoidance of strenous exercice and jumping sports may be satisfactory. Symptoms will desappear after fusion of the tibial tubercle apophisys, although enlargement of the tubercle may be permanent.
1.Polakopf DR, Bucholz RW, Ogden JA: Tensoion band wires of displaced tibial fractures in adolecents.Clin Orthop.1986; 209:161-165.
2.Ogden JA, Southwick WO: Osgood schlatter`s disease in tibial tuberosity development. Clin. Orthop.1976; 116: 180-189.
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