EMedHome's Clinical Pearl
Adolescent tibial tubercle avulsion fractures are uncommon, but are clinically significant because anterior compartment syndrome can result in 10-20 percent of cases, according to studies. (Am J Emerg Med. 2019;37:1603.e3-1603.e5; J Child Orthop. 2008;2:469; http://bit.ly/2kuIlVF.)
Compartment syndrome is a potentially devastating injury that can occur with tibial tubercle avulsion fracture because of underappreciated local soft tissue injury or the fractured component rupturing the anterior tibial recurrent artery.
Anterior compartment syndrome has been shown to occur in four to 20 percent of patients in various case series. (J Pediatr Orthop. 2016;36:440.)
Careful consideration of compartment syndrome as a possible complication of tibial tubercle fractures is recommended with a high level of vigilance and close monitoring. (Case Rep Orthop. 2018 Aug 2; doi: 10.1155/2018/1070628; http://bit.ly/2kCOsHn.)
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