A Rare Case of Combined Tibial Plateau Fracture with Tibial Tuberosity Avulsion Injury: Case Report.

BACKGROUND

Avulsion fracture of the tibial tuberosity is a rare orthopedic injury, predominantly affecting adolescents but seldom seen in the adult population. Lateral tibial plateau fractures, while more common, infrequently present combined with tibial tuberosity avulsion. No established classification system currently describes or guides management for cases featuring both lateral tibial plateau split fracture and tibial tuberosity avulsion.

CASE REPORT: This report describes a 30-year-old male presenting with acute knee pain and swelling following a road traffic accident. Radiographic evaluation revealed a unique combination of lateral tibial plateau split fracture and displaced tibial tuberosity avulsion. The patient underwent surgical fixation through an anterolateral approach, utilizing a lateral proximal tibial plate for the plateau fracture and lag screws with tension band wiring for the tuberosity avulsion. Early post-operative mobilization was implemented to mitigate the risk of stiffness.

DISCUSSION: While tibial tuberosity fractures are historically documented in pediatric populations, their occurrence with isolated split lateral tibial plateau fractures in adults is exceptionally rare. A thorough review of the literature yielded only isolated reports of similar injury patterns, often within multi-fragmentary or bicondylar fractures. Proper radiological assessment and targeted internal fixation are crucial for optimal outcomes. Addressing the tuberosity avulsion is essential to restore extensor mechanism integrity and prevent non-union.

CONCLUSION

Simultaneous isolated split lateral tibial plateau fracture and tibial tuberosity avulsion highlight an uncommon injury pattern, warranting vigilance during diagnosis and treatment. Early surgical intervention and rehabilitation achieve favorable functional results.