Rehabilitation of Surgical Repair of Bilateral Tibial Tuberosity Avulsion Fracture
Abstract
Background: An avulsion fracture of the tibial tuberosity in adolescents is a rare injury, only occurring in 0.4% to 2.7% of the population. Bilateral avulsions are even more rare. This injury is typically seen in males who participate in sports with jumping and tackling actions. This is a case of a fourteen-year-old male, multi-sport athlete who sustained simultaneous bilateral tibial tuberosity avulsion fractures. Methods: The athlete sustained bilateral avulsions during a warm up for the triple jump at track practice. The athlete underwent immediate, surgical, and rehabilitative treatment. This case presents the purpose and outcome of all three treatment types. The treatment data was collected over a thirteen-week timespan from documentation collected by the school’s Athletic Trainer. Results: The athlete was immediately transported to the hospital for surgery post injury. The athlete was non-weight bearing for ten weeks post-operative repair. Once weight bearing, range of motion, strength, gait, and sport specific skills were all retrained. Uniqueness: The left knee was more severe when compared bilaterally. This leg sustained a hamstring strain 6 months prior. The athlete progressed through range of motion quickly. At the end of week 2, he actively flexed to 45° and began week 3 with 60° passively. The physician’s goal was for him to be there by the end of week 6. The accelerated rate that this athlete progressed at attributed to the uniqueness of this case. The rehabilitative treatment was consistently adjusted based on the athlete's progression. Conclusion: This case is presented for its uniqueness and educational review of the mechanism of injury and discussion of the treatment and rehabilitation processes. Although rare, it is important for clinicians to be able to recognize and rehabilitate tibial tuberosity avulsion fractures effectively.
Rehabilitation of Surgical Repair of Bilateral Tibial Tuberosity Avulsion Fracture
Background: An avulsion fracture of the tibial tuberosity in adolescents is a rare injury, only occurring in 0.4% to 2.7% of the population. Bilateral avulsions are even more rare. This injury is typically seen in males who participate in sports with jumping and tackling actions. This is a case of a fourteen-year-old male, multi-sport athlete who sustained simultaneous bilateral tibial tuberosity avulsion fractures. Methods: The athlete sustained bilateral avulsions during a warm up for the triple jump at track practice. The athlete underwent immediate, surgical, and rehabilitative treatment. This case presents the purpose and outcome of all three treatment types. The treatment data was collected over a thirteen-week timespan from documentation collected by the school’s Athletic Trainer. Results: The athlete was immediately transported to the hospital for surgery post injury. The athlete was non-weight bearing for ten weeks post-operative repair. Once weight bearing, range of motion, strength, gait, and sport specific skills were all retrained. Uniqueness: The left knee was more severe when compared bilaterally. This leg sustained a hamstring strain 6 months prior. The athlete progressed through range of motion quickly. At the end of week 2, he actively flexed to 45° and began week 3 with 60° passively. The physician’s goal was for him to be there by the end of week 6. The accelerated rate that this athlete progressed at attributed to the uniqueness of this case. The rehabilitative treatment was consistently adjusted based on the athlete's progression. Conclusion: This case is presented for its uniqueness and educational review of the mechanism of injury and discussion of the treatment and rehabilitation processes. Although rare, it is important for clinicians to be able to recognize and rehabilitate tibial tuberosity avulsion fractures effectively.