Avulsion fracture of the anterior tibial apophysis

Case contributed by Guilherme Pioli Resende
Diagnosis certain

Presentation

Patient admitted with acute pain after jumping from his own height.

Patient Data

Age: 16 years
Gender: Male

Avulsion fracture of the anterior tibial apophysis, with proximal dislocation and inclination of bone fragments, the largest measuring 2.5 cm, 2 cm and 1.2 cm. High riding patella (Caton-Deschamps = 2), with thickening and irregularity of the patellar tendon (8 mm).

Postoperative exam, with plaster cast immobilization and reinsertion of the tibial tuberosity/patellar tendon (Caton-Deschamps = 1).

Case Discussion

Avulsion fractures of the anterior tibial apophysis are an unusual finding, with a mechanism related to the eccentric contraction of the quadriceps femoris muscle at the beginning of the jump or on landing. Treatment is typically surgical.

Contributed by Dr. Hemilianna Hadassa Silva Matozinho M.D. and Dr. Arthemizio Antônio Lopes Rocha M.D.

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