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Am J Emerg Med. 2019 May 17. pii: S0735-6757(19)30344-4. doi: 10.1016/j.ajem.2019.05.033. [Epub ahead of print]

Bilateral tibial tubercle avulsion fractures: A pediatric orthopedic injury at high risk for compartment syndrome.

Author information

1
School of Medicine, Uniformed Services University of the Health Sciences, United States of America. Electronic address: Ivan.yue@usuhs.edu.
2
Department of Military Emergency Medicine, Uniformed Services University of the Health Sciences, United States of America.
3
Department of Pediatric Orthopedics, University of California at San Diego-Rady Children's Hospital, United States of America.
4
Department of Pediatrics, Division of Emergency Medicine, University of California at San Diego-Rady Children's Hospital, United States of America.
5
Department of Pediatric Emergency Medicine, University of California at San Diego -Rady Children's Hospital, United States of America.

Abstract

Adolescent tibial tubercle avulsion fractures represent an uncommon, but clinically significant condition for emergency medicine physicians. Early recognition of the signs and symptoms of this pediatric orthopedic diagnosis are important, as anterior compartment syndrome can occur in up to 10-20% of cases. Anterior tibial tubercle fractures are generally sport related injuries, occurring primarily in otherwise healthy adolescent males between the ages of 11-17. They account for less than 3% of all epiphyseal injuries in this age group and are rarely bilateral in nature. In this article, we present a case with two unique clinical features: bilateral sports related tibial tubercle avulsion fractures and subsequent development of bilateral clinical compartment syndrome. We briefly review the risk factors, presentation, and diagnosis of this rare but clinically important condition.

PMID:
31126670
DOI:
10.1016/j.ajem.2019.05.033

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