Orthopaedic Unit, Oglio Po Hospital, Vicomoscano (CR), ASST Cremona, Italy.
Orthopaedic and Traumatology Clinic, Department of Medicine and Surgery, University of Parma, Parma, Italy.
Acta Biomed. 2022 Mar 10;92(S3):e2021571. doi: 10.23750/abm.v92iS3.12580.
Tibial tubercle avulsion fractures (TTAF) are uncommon condition in children and adolescents. These lesions may be misdiagnosed and consequently not properly treated. Reduction and fixation is indicated if displacement is higher than 2mm or if the extensor apparatus is damaged. Authors present a case of a TTAF associated with a complete lateral patellar retinaculum lesion in a 13-year-old male adolescent non-professional basketball player.
Surgery consisted of reduction and fixation with 2 half threaded cancellous and washers; TTA was then basted and reinforced with a non absorbable suture according to Krachow technique and finally the patellar lateral retinaculum through a direct repair with absorbable material.
Clinical evaluation after 3 years showed bone healing, a complete resolution of pain, complete range of motion, good strength and complete functionality of the operated limb.
Misdiagnosis or delayed treatment of TTAF can often result in nonunion, functional impairment, and persistent pain. For these reasons, authors believe that a stable and quick fixation associated to specialized rehabilitation are crucial for recovery. (www.actabiomedica.it).
胫骨结节撕脱骨折（TTAF）在儿童和青少年中较为少见。这些损伤可能会被误诊，从而得不到适当的治疗。如果移位超过 2 毫米或伸肌装置受损，则需要进行复位和固定。作者介绍了一名 13 岁男性非职业篮球运动员的胫骨结节撕脱骨折，伴有完全外侧髌旁支持带损伤。
手术包括复位和 2 枚半螺纹松质骨螺钉和垫圈固定；然后根据 Krachow 技术用不可吸收缝线进行胫骨结节缝合加固，最后用可吸收材料直接修复髌旁外侧支持带。
3 年后的临床评估显示骨愈合，疼痛完全缓解，活动范围完全恢复，患肢力量和功能良好。
胫骨结节撕脱骨折的误诊或延迟治疗常可导致骨不连、功能障碍和持续性疼痛。因此，作者认为稳定和快速的固定以及专业的康复治疗对于恢复至关重要。（www.actabiomedica.it）。
