![]() ![]() Common complications following TSAF injury and treatment are residual laxity, knee stiffness, and nonunion or malunion. All-epiphyseal or transphyseal approaches can minimize the risk of physeal injury in skeletally immature patients. Type III fractures are indicated directly for arthroscopic surgery and both suture and screw fixation produce good clinical outcomes. Type I fractures are usually treated with immobilization whereas type II fractures typically undergo an initial attempt at closed reduction followed by arthroscopic or open reduction and fixation if needed. TSAFs can be classified using plain radiographs as well as MRI. A recently developed MRI-based system for evaluating TSAFs is another tool that aids in the treatment of these injuries. The avulsion fracture of the tibial tuberosity is an uncommon injury of the knee, which predominantly occurs in adolescence, mainly in boys. Type IV tibial tuberosity avulsion presents with fracture extension from the tibial tuberosity, posteriorly through the proximal tibial physis, and then into. There are numerous sites at which these occur. Avulsion fractures are commonly distracted due to the high tensile forces involved. ![]() (n.s) There was a significant positive correlation between the amount of initial avulsion fracture displacement and side-to-side difference in posterior stress radiographs at final follow up (P < 0.001). Avulsion injuries or fractures occur where the joint capsule, ligament, tendon or muscle attachment site is pulled off from the bone, usually taking a fragment of cortical bone. Finally, we will review outcomes following treatment, including common complications.Īlthough TSAFs only constitute 2-5% of all pediatric knee injuries, the incidence is increasing. There were 5 (16.6) failures of non-operative treatment in the PCL avulsion fracture group and 19 (27.1) failures in the PCL injury group. We will also compare guidelines for nonsurgical versus surgical treatment and summarize frequently used surgical techniques. 1 They are commonly associated with sports injuries like those usually seen during hyperextension combined with a rotational injury of the knee. We will discuss how these fractures are classified both on plain radiographs and MRI as well as report the incidence of concomitant soft tissue injury, an important consideration that guides treatment. Anterior cruciate ligament (ACL) avulsion injuries from the tibial side are seen most commonly among children and young adults. The purpose of this review is to summarize and clarify the current framework for treating tibial spine avulsion fractures (TSAFs). ![]()
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