Tibial tubercle avulsion fractures in children and adolescents

Abstract Tibial tubercle avulsion fractures (TTAFs) are uncommon injuries in the pediatric population, predominantly affecting children and adolescents who are approaching skeletal maturity and frequently engage in high‐energy activities. Despite of their rarity, TTAFs can significantly impact the l...

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Main Authors: Hailun Yao, Yuanlin He, Xiang Li, Mingyan Shi, Peikang Wang, Man Zhang, Xinkai Zhang, Xing Liu
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:Pediatric Discovery
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Online Access:https://doi.org/10.1002/pdi3.2521
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author Hailun Yao
Yuanlin He
Xiang Li
Mingyan Shi
Peikang Wang
Man Zhang
Xinkai Zhang
Xing Liu
author_facet Hailun Yao
Yuanlin He
Xiang Li
Mingyan Shi
Peikang Wang
Man Zhang
Xinkai Zhang
Xing Liu
author_sort Hailun Yao
collection DOAJ
description Abstract Tibial tubercle avulsion fractures (TTAFs) are uncommon injuries in the pediatric population, predominantly affecting children and adolescents who are approaching skeletal maturity and frequently engage in high‐energy activities. Despite of their rarity, TTAFs can significantly impact the lives of young individuals involved in sports and other strenuous activities. The mechanism of TTAFs occurrence involves forceful quadriceps contraction against resistance or rapid knee flexion with contracted quadriceps. TTAFs may coincide with other related injuries due to their mechanism of occurrence and commonly present with an abrupt onset of pain, focal soft‐tissue swelling and tenderness on palpation. Predisposing factors such as a history of Osgood‐Schlatter disease and an extreme body mass index (BMI) could contribute to TTAFs susceptibility. Diagnosis of TTAFs typically relies on X‐rays, complemented by computed tomography (CT) and magnetic resonance imaging (MRI) for screening associated injuries and preoperative assessment. While a well‐established classification system exists, with the Ogden classification being the most commonly employed, intriguingly, a direct correlation between fracture type and treatment method, as well as the choice of surgical fixation modality, remains elusive. The management of TTAFs encompasses both conservative and surgical approaches, with open reduction internal fixation (ORIF) being the predominant surgical method and the prognosis for this condition is generally favorable. By synthesizing existing knowledge and presenting potential areas of uncertainty, this review aims to offer valuable insights to orthopedic practitioners when they are confronted with this infrequent injury.
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spelling doaj-art-a7214039beb841ccb79a514be4f7a2872025-08-20T02:49:06ZengWileyPediatric Discovery2835-558X2835-55982025-03-0131n/an/a10.1002/pdi3.2521Tibial tubercle avulsion fractures in children and adolescentsHailun Yao0Yuanlin He1Xiang Li2Mingyan Shi3Peikang Wang4Man Zhang5Xinkai Zhang6Xing Liu7Department of Orthopedics Ministry of Education Key Laboratory of Child Development and Disorders National Clinical Research Center for Child Health and Disorders China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics Children's Hospital of Chongqing Medical University Chongqing ChinaWest China School of Medicine Sichuan University Chengdu ChinaDepartment of Orthopedics Ministry of Education Key Laboratory of Child Development and Disorders National Clinical Research Center for Child Health and Disorders China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics Children's Hospital of Chongqing Medical University Chongqing ChinaDepartment of Orthopedics Ministry of Education Key Laboratory of Child Development and Disorders National Clinical Research Center for Child Health and Disorders China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics Children's Hospital of Chongqing Medical University Chongqing ChinaDepartment of Orthopedics Ministry of Education Key Laboratory of Child Development and Disorders National Clinical Research Center for Child Health and Disorders China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics Children's Hospital of Chongqing Medical University Chongqing ChinaDepartment of Orthopedics Ministry of Education Key Laboratory of Child Development and Disorders National Clinical Research Center for Child Health and Disorders China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics Children's Hospital of Chongqing Medical University Chongqing ChinaDepartment of Orthopedics Ministry of Education Key Laboratory of Child Development and Disorders National Clinical Research Center for Child Health and Disorders China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics Children's Hospital of Chongqing Medical University Chongqing ChinaDepartment of Orthopedics Ministry of Education Key Laboratory of Child Development and Disorders National Clinical Research Center for Child Health and Disorders China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics Children's Hospital of Chongqing Medical University Chongqing ChinaAbstract Tibial tubercle avulsion fractures (TTAFs) are uncommon injuries in the pediatric population, predominantly affecting children and adolescents who are approaching skeletal maturity and frequently engage in high‐energy activities. Despite of their rarity, TTAFs can significantly impact the lives of young individuals involved in sports and other strenuous activities. The mechanism of TTAFs occurrence involves forceful quadriceps contraction against resistance or rapid knee flexion with contracted quadriceps. TTAFs may coincide with other related injuries due to their mechanism of occurrence and commonly present with an abrupt onset of pain, focal soft‐tissue swelling and tenderness on palpation. Predisposing factors such as a history of Osgood‐Schlatter disease and an extreme body mass index (BMI) could contribute to TTAFs susceptibility. Diagnosis of TTAFs typically relies on X‐rays, complemented by computed tomography (CT) and magnetic resonance imaging (MRI) for screening associated injuries and preoperative assessment. While a well‐established classification system exists, with the Ogden classification being the most commonly employed, intriguingly, a direct correlation between fracture type and treatment method, as well as the choice of surgical fixation modality, remains elusive. The management of TTAFs encompasses both conservative and surgical approaches, with open reduction internal fixation (ORIF) being the predominant surgical method and the prognosis for this condition is generally favorable. By synthesizing existing knowledge and presenting potential areas of uncertainty, this review aims to offer valuable insights to orthopedic practitioners when they are confronted with this infrequent injury.https://doi.org/10.1002/pdi3.2521growth platepediatricskeletal maturitytibial tubercle avulsion fractures (TTAFs)
spellingShingle Hailun Yao
Yuanlin He
Xiang Li
Mingyan Shi
Peikang Wang
Man Zhang
Xinkai Zhang
Xing Liu
Tibial tubercle avulsion fractures in children and adolescents
Pediatric Discovery
growth plate
pediatric
skeletal maturity
tibial tubercle avulsion fractures (TTAFs)
title Tibial tubercle avulsion fractures in children and adolescents
title_full Tibial tubercle avulsion fractures in children and adolescents
title_fullStr Tibial tubercle avulsion fractures in children and adolescents
title_full_unstemmed Tibial tubercle avulsion fractures in children and adolescents
title_short Tibial tubercle avulsion fractures in children and adolescents
title_sort tibial tubercle avulsion fractures in children and adolescents
topic growth plate
pediatric
skeletal maturity
tibial tubercle avulsion fractures (TTAFs)
url https://doi.org/10.1002/pdi3.2521
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AT mingyanshi tibialtubercleavulsionfracturesinchildrenandadolescents
AT peikangwang tibialtubercleavulsionfracturesinchildrenandadolescents
AT manzhang tibialtubercleavulsionfracturesinchildrenandadolescents
AT xinkaizhang tibialtubercleavulsionfracturesinchildrenandadolescents
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