Emergency: requires immediate attention
Tibial eminence fracture
Alerts and Notices
Synopsis
Causes / typical injury mechanism: Tibial eminence fractures, or tibial spine avulsion fractures, tend to occur in patients aged 8-14 years as a result of trauma to the knee. Common mechanisms of injury can include falling off a bike, motor vehicle accidents, and athletic participation, resulting in a twisting injury to the knee.Classic history and presentation: The condition presents as severe knee pain and effusion due to hemarthrosis, limited range of motion (ROM), and difficulty bearing weight on the affected side. Patient history includes a trauma to the affected knee with resulting hyperextension. Patients with tibial eminence fractures may present with knee instability.
Prevalence: Tibial eminence fractures, or tibial spine avulsion fractures, are very rare in the adult population and infrequent in pediatric patients, occurring in only 3 in 100 000 children who sustain knee trauma per year.
- Age – Tibial spine avulsion fractures can occur at any age, but typically occur in patients aged 8-14 years.
- Sex / gender – No difference in occurrence has been observed.
- Young age (skeletally immature)
- Athletic participation (biking, soccer, skiing, etc)
Grade / classification system: The Meyers and McKeever Classification was published in 1959 and has been used to classify the degree of fracture and determine treatment methods.
- Type I fractures are nondisplaced (< 3 mm)
- Type II fractures are partially displaced with intact posterior hinge
- Type IIIA fractures are completely displaced and not rotated
- Type IIIB fractures are completely displaced and rotated
- Type IV (added by Zaricznyj in 1977) fractures are completely displaced, rotated, and comminuted
Codes
ICD10CM:S82.113A – Displaced fracture of unspecified tibial spine, initial encounter for closed fracture
S82.116A – Nondisplaced fracture of unspecified tibial spine, initial encounter for closed fracture
SNOMEDCT:
281843000 – Fracture of tibial spine
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Differential Diagnosis & Pitfalls
- ACL tear
- Meniscal tear
- Lateral collateral ligament (LCL) injury
- Medial collateral ligament (MCL) injury
- Posterior cruciate ligament (PCL) tear
- Patellar fracture
- Patellar dislocation
- Osteochondral defect
- Femoral condyle fracture
- Distal femoral physeal fracture
- Distal femoral fracture
- Tibial plateau fracture
- Proximal third tibial fracture
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Last Reviewed:03/10/2021
Last Updated:03/10/2021
Last Updated:03/10/2021
Emergency: requires immediate attention
Tibial eminence fracture