EURORAD ESR

Case 14039

Avulsion fracture of the tibial tubercle in an adolescent

Author(s)
Charlotte Vanhoenacker 1, Kris Van Crombrugge 2, Lieven Tack 2, Filip Vanhoenacker 2, 3, 4

1: Leuven University Hospital,
Department of Radiology,
3000 Leuven, Belgium
2: AZ Sint-Maarten Duffel-Mechelen,
Departments of Orthopedic Surgery,
Emergency and Radiology;
Leopoldstraat 2,
2800 Mechelen, Belgium
3: Ghent University Hospital,
Department of Radiology;
De Pintelaan 185,
9000 Ghent, Belgium
4: Antwerp University Hospital,
Department of Radiology; W
ilrijkstraat 10,
2650 Antwerp, Belgium
 
Patient
male, 13 year(s)
 
 
  • Figure 1
    Plain radiograph of the left knee: Anteroposterior and Lateral view

    Lateral view: Soft tissue swelling (red arrow) and broadening of the growth plate of the apophysis of the tibial tubercle (yellow star).

     
    Area of Interest: Musculoskeletal joint; Imaging Technique: Plain radiographic studies; Procedure: Diagnostic procedure; Special Focus: Trauma;
     
     
  • Figure 2
    MRI scan: sagittal T1 and T2 weighted images

    1. Undulating course of patellar tendon (red arrow), adjacent soft tissue swelling. Bone marrow oedema in ventral proximal tibial epiphysis (yellow arrow) indicating lesion extension in the knee joint. 2. Broadening...

     
    Area of Interest: Musculoskeletal joint; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Trauma;
     
     
  • Figure 3
    Modified Watson-Jones classification [5]

    I: Upward displacement of tibial tubercle (TT). II: Fracture extension through the articular surface. III: Upward displacement of TT together with ossified part of tibial epiphysis. IV: Fracture through growth...

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: Conventional radiography; Procedure: Normal variants; Special Focus: Trauma;
     
     
  • Figure 4
    Postoperative radiographs: Anteroposterior and lateral view

    The avulsion fracture was treated surgically with open reduction and internal fixation with four cortical screws. Postoperative X-ray shows correct alignment of fracture and correct position of screws.

     
    Area of Interest: Musculoskeletal joint; Imaging Technique: Plain radiographic studies; Procedure: Diagnostic procedure; Special Focus: Trauma;
     
     
Lateral view: Soft tissue swelling (red arrow) and broadening of the growth plate of the apophysis of the tibial tubercle (yellow star).
 
1. Undulating course of patellar tendon (red arrow), adjacent soft tissue swelling. Bone marrow oedema in ventral proximal tibial epiphysis (yellow arrow) indicating lesion extension in the knee joint. 2. Broadening of the growth plate (star).
 
I: Upward displacement of tibial tubercle (TT). II: Fracture extension through the articular surface. III: Upward displacement of TT together with ossified part of tibial epiphysis. IV: Fracture through growth plate of proximal tibial epiphysis.
 
The avulsion fracture was treated surgically with open reduction and internal fixation with four cortical screws. Postoperative X-ray shows correct alignment of fracture and correct position of screws.
 
 
 
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