Revista de la Asociación Argentina de Ortopedia y Traumatología
On-line version ISSN 1852-7434
LEVY, Eduardo J.; GARABANO, Germán; ROBADOR, Nicolás and SEL, Hernán del. Fractures of the anterior tibial tuberosity in adolescentes with immature skeleton. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2012, vol.77, n.1, pp. 39-44. ISSN 1852-7434.
Background: Fractures of the anterior tibial tuberosity (ATT) account for approximately 3% of all proximal tibial fractures, and occur more frequently in males aged 12 to 17 in the context of sporting activities. Methods: Between 1995 and 2008, 23 ATT fractures were treated in 20 patients. The series was comprised of 18 men and 2 women with an average age of 13.4. Fractures were classified according to the Ogden classification. There were 11 type 1 (5A and 6B); 6 type 2 (3A and 3B) and 5 type 3 (2 subtype A, 3 subtype B). Type 1 and 2A fractures were managed with immobilization, while the remaining required open reduction, internal fixation and immobilization. Results: Bone healing was seen in all patients. 95% returned to their previous sports activity. Hardware caused pain in one patient and one developed a recurvatum. Conclusions: ATT fractures are uncommon. A better understanding of the proximal tibial ossification pattern may lead to a correct diagnosis. It is also important to differentiate it from the Osgood-Schlatter disease, avoiding possible sequelae such as a traumatic patella alta. Considering the Ogden classification we obtained good results with conservative treatment for 1AB and 2A fractures, and open reduction and internal fixation for the 2B and 3AB.
Keywords : Fractures of the anterior tibial tuberosity (ATT); Osgood-Schlatter; Adolescent; Ogden; Cartilage growth; Recurvatum.