![]() ![]() Usually this injury is a stretch injury to the fibers of the ACL rather than a midsubstance disruption. MRI may identify an injury to the fibers of the ACL in addition to the tibial spine fracture. MRI can be useful to identify associated meniscal tears and chondral injuries as well as barriers to reduction including the meniscus and intermeniscal ligament (Mitchell 2015). Plain radiographs, particularly the lateral radiograph identify the injury, and guide treatment. This classification system had been modified by Zaricznyj to include type IV or comminuted fractures. Type III fractures are completely displaced from the proximal tibia. Type II fractures are displaced anteriorly with an intact posterior hinge. (Meyers 1959) Type I fractures are nondisplaced or minimally displaced. Patients who sustain these injuries typically present with a painful hemarthrosis and the inability to fully extend their knee.įractures are identified as type I, II, and III by the Meyers and McKeever classification. The fracture may extend into the medial and lateral tibial articular surfaces. Tibial spine fractures occur through the subchondral bone at the base of the medial tibial spine and are ACL equivalent injuries. The ACL inserts on the medial tibial spine. The term tibial eminence refers to the area between the medial and lateral tibia plateaus on the proximal tibia, and consists of the medial and lateral tibial spines. Prompt recognition and management of these injuries can decrease morbidity and minimize long term complications. The immature tibial spine is weaker than the ACL. The injury creates traction forces along the anterior cruciate ligament (ACL) and causes avulsion of the tibial spine. They have classically been associated with a hyperextension injury to the knee as a result of a bike accident. These injuries can occur during sporting endeavors. ![]() While these injuries can occur in adults, they are more common in skeletally immature patients between ages 8-14. Tibial spine fractures are relatively uncommon injuries that typically occur at the base of the tibial spine. Although ACL laxity can commonly occur due to ligamentous stretch during injury, this laxity is rarely clinically significant if the fracture is properly treated.The meniscus and intermeniscal ligament can be barriers to reduction.Tibial spine fractures are ACL equivalent injuries, and should be operatively managed if displaced.Study Guide Tibial Spine Fractures Key Points: ![]()
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