Diagnosis of Avulsed Anterior Tibial Spine

Abstract

Background: Avulsion fractures of the tibial spine (intercondylar eminence) are rare but have clinical significance, especially in children and adolescents. These injuries are commonly seen in conjunction with anterior cruciate ligament (ACL) injuries, and in the early stages, can be missed or incorrectly diagnosed as simple knee sprains. The key components to reaching an accurate diagnosis include looking at a full clinical picture and utilizing a suite of imaging techniques. The consequences of missing a diagnosis can be serious and include ongoing pain, an inability to extend the knee, knee instability, and a decrease in function and the ability to perform activity. This paper reviews the literature on the epidemiology, clinical presentation, and physical examination findings of associated injuries and outlines the contribution of imaging in the diagnosis of tibial spine avulsion fractures.