Imaging Review of Adolescent Tibial Tuberosity Fractures


Adolescent tibial tuberosity injuries are infrequent fractures usually seen in physically active adolescent males. Powerful contraction of the knee extensors by sudden acceleration or deceleration of the quadriceps muscle can result in avulsion fractures of the tibial tuberosity apophysis. In late puberty, as the growth plate closes, it is transiently replaced by fibrocartilaginous elements. This transition causes a period of weakened tensile strength, which predisposes the tibial tuberosity to traction injury. Classification of tibial tuberosity fractures includes types I-V with added A and B subsets to types I, II and III. Multidetector computed tomography (MDCT) is a useful tool to more accurately classify complex, higher grade adolescent tibial tuberosity avulsion fractures when compared to plain film. This aids in preoperative planning and, therefore, results in improved treatment and management.

Share and Cite:

P. Chitkara, R. Anne, S. Lavianlivi, S. Lehto and S. Kolla, "Imaging Review of Adolescent Tibial Tuberosity Fractures," Open Journal of Medical Imaging, Vol. 3 No. 3, 2013, pp. 90-96. doi: 10.4236/ojmi.2013.33014.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] B. E. McKoy and C. L. Stanitski, “Acute Tibial Tubercle Avulsion Fractures,” Orthopedic Clinics of North Amer- ica, Vol. 34, No. 3, 2003, pp. 397-403. doi:10.1016/S0030-5898(02)00061-5
[2] S. Frey, et al., “Tibial Tuberosity Fractures in Adolescents,” Journal of Children’s Orthopaedics, Vol. 2, No. 6, 2008, pp. 469-474. doi:10.1007/s11832-008-0131-z
[3] S. M. Mosier, C. L. Stanitski and R. S. Levine, “Simultaneous Bilateral Tibial Tubercle Avulsion Fracture,” Orthopedics, Vol. 23, No. 10, 2000, pp. 1106-1108.
[4] M. J. Bolesta and R. D. Fitch, “Tibial Tubercle Avulsions,” Journal of Pediatric Orthopaedics, Vol. 6, No. 2, 1986, pp. 186-192. doi:10.1097/01241398-198603000-00013
[5] R. Watson-Jones, “Fractures and Joint Injuries,” 4th Edition, Williams & Wilkins, Baltimore, 1955.
[6] J. A. Ogden, et al., “Fractures of the Tibial Tuberosity in Adolescents,” Journal of Bone and Joint Surgery (American Volume), Vol. 62, No. 2, 1980, pp. 205-215.
[7] S. A. Buhari, S. Singh, et al., “Tibial Tuberosity Fractures in Adolescents,” Singapore Medical Journal, Vol. 34, No. 5, 1993, pp. 421-424.
[8] J. A. Ogden, W. O. Southwick, “Osgood-Schlatter’s Disease and Tibial Tuberosity Development,” Clinical Orthopaedics and Related Research, No. 116, 1976, pp. 180-189.
[9] G. Ehrenborg, B. Engfeldt, “The Insertion of the Ligamentum Patellae on the Tibial Tuberosity. Some Views in Connection with the Osgood-Schlatter Lesion,” Acta chirurgica Scandinavica, Vol. 121, 1961, pp. 491-499.
[10] J. A. Ogden, R. J. Hempton and W. O. Southwick, “Development of the Tibial Tuberosity,” The Anatomical Record, Vol. 182, No. 4, 1975, pp. 431-445. doi:10.1002/ar.1091820404
[11] R. K. Ryu and J. O. Debenham, “An Unusual Avulsion Fracture of the Proximal Tibial Epiphysis. Case Report and Proposed Addition to the Watson-Jones Classification,” Clinical Orthopaedics and Related Research, No. 194, 1980, pp. 181-184.
[12] U. Frankl, S. A. Wasilewski and W. L. Healy, “Avulsion Fracture of the Tibial Tubercle with Avulsion of the Patellar Ligament. Report of Two Cases,” Journal of Bone and Joint Surgery (American Volume), Vol. 72, No. 9, 1990, pp. 1411-1413.
[13] T. Pesl and P. Havranek, “Acute Tibial Tubercle Avulsion Fractures in Children: Selective Use of the Closed Reduction and Internal Fixation Method,” Journal of Children’s Orthopaedics, Vol. 2, No. 6, 2008, pp. 469- 474.
[14] B. K. K. Fung and Y. H. Li, “Avulsion Fracture of the Tibial Tubercle and Proximal Tibialphysis,” Hong Kong Journal of Orthopaedic Surgery, Vol. 5, No. 1, 2001, pp. 70-73.
[15] C. S. Dupuis, S. J. Westra, J. Makris and E. C. Wallace, “Injuries and Conditions of the Extensor-Mechanism of the Pediatric Knee,” Radiographics, Vol. 29, 2009, pp. 877-886. doi:10.1148/rg.293085163
[16] A. Jalgaonkar, S. Dachepalli, et al., “Atypical Tibial Tuberosity Fracture in an Adolescent,” Orthopedics, Vol. 34, No. 6, 2011, p. 215.
[17] S. P. Chow, et al., “Fracture of the Tibial Tubercle in the Adolescent,” The Bone & Joint Journal (British Volume), Vol. 72, No. 2, 1990, pp. 231-234.

Copyright © 2022 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.