- Classically described in pediatric patients and considered the childhood equivalent of anterior cruciate ligament (ACL) ruptures in adults
- Forceful hyperextension of the knee resulting in avulsive force/tension on ACL, which inserts into the anterior tibial spine. Possibly with valgus stress or rotation.
- In adults, most injuries occur in road-traffic accidents and are isolated
- Adults more likely to have associated tear of medial collateral ligament (MCL) or intra-articular fracture
- Based on degree of displacement. Type II & III are most common
- Type I = incomplete avulsion of tibial spine without displacement
- Type II = incomplete avulsion with anterior elevation of the fragment
- Type IIIA = complete separation of fragment
- Type IIIB = rotated and comminuted fragment
- Generally, types I and II are managed conservatively while type III fractures are managed arthroscopically or with open reduction
Kendall NS, et al. Fracture of the tibial spine in adults and children. J Bone J Surg [Br] 1992;74-B:848-52.
Rosen's Emergency Medicine - Concepts and Clinical Practice