Hakan SELEK, Haluk YETKİN, Sacit TURANLI, Hamza ÖZER

Ogden type IIIA tibial tuberosity fractures in two adolescent males

Adolesan çağda tibial tüberkülün komplet avülsiyon kırıkları oldukça nadir rastlanan yaralanmalardır. Tibial tüberkülün aseptik nekrozu (Osgood-Schlatter hastalığı) önemli bir predispozan faktördür. Genç erişkinlerde diz çevresindeki ligamentöz yaralanmalarda, fizik aktivitenin süresi ve yoğunluğu büyük rol oynar. Biz bu yazımızda Ogden tip IIIA tibial tüberkül avülsiyon kırığı olan iki hasta sunuyoruz. Hastaların birinde yaralanma öncesi bilinen Osgood-Schlatter hastalığı mevcutken, diğer hastanın postoperatif dönemdeki muayenesinde hamsting kaslarının gergin olduğu izlendi. Her iki hastada, futbol maçı esnasında koşerken kırık meydana gelmişti. Hastalara, kanüle vida ile açık redüksiyon internal fiksasyon yapıldı. Her iki hastada yaklaşık iki yıldan beri takibimizde olup, herhangi bir komplikasyon görülmemiştir.

Adolesan iki erkek hastada ogden tip IIIA tibial tüberkül kırığı

Complete avulsion fracture of the tibial tuberosity is rarely seen in adolescents. Aseptic necrosis (Osgood-Schlatter disease) of the tibial tuberosity is a predisposing factor. The duration and intensity of physical activities play major roles in ligamentous injuries around the knee joint in adolescents. Two patients with Ogden type IIIA avulsion fracture of the tibial tuberosity are presented here. One patient had been diagnosed with Osgood-Schlatter disease before the injury, and the other was postoperatively found to have tight hamstrings. Both fractures occurred while the patients were running during football matches. Both were treated with open reduction and internal fixation with cannulated screws. During the two-year follow-up, no complications were detected.

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1. Falster O, Hasselbach H. Avulsion fracture of the tibial tuberosity with combined ligament and meniscal tear. Am J Sports Med 1992; 20: 82-83.
2. Mirbey J, Besancenot J, Chambers RT, Durey A, Vichard P. Avulsion fractures of the tibial tuberosity in the adolescent athlete. Am J Sports Med 1988; 16: 336-340.
3. Ogden JA, Tross RB, Murphy MJ. Fractures of the tibial tuberosity in adolescents. J Bone Joint Surg 1980; 62-A: 205-215.
4. Choi NM, Kim NM. Tibial tuberosity avulsion fracture combined with meniscal tear. Arthroscopy 1999; 15: 766-769.
5. Ergun M, Taşkıran E, Özgürbüz C. Simultaneous bilateral tibial tubercle avulsion fracture in a basketball player. Knee Surg Sport Traumatol Arthrosc 2003; 11: 163-166.
6. Özer H, Turanlı S, Baltacı G, Tekdemir İ. Avulsion of the tibial tuberosity with a lateral plateau rim fracture: case report. Knee Surg Sports Traumatol Arthrosc 2002; 10: 310-312.
7. Ryu RKN, Debenham JO. An unusual avulsion fracture of the proximal tibial epiphysis. Clin Orthop 1983; 194: 181-184.
8. De Lee JC, Drez D. Orthopedic Sports Medicine. Philadelphia: WB Saunders, 1996.
9. Nikiforidis PA, Babis GC, Triantafillopoulos IK,Themistocleous GS,Nikolopoulos K. Avulsion fractures of the tibial tuberosity in adolescent athletes treated by internal fixation and tension band wiring. Knee Surg Sport Traumatol Arthrosc 2004; 12: 271-276.
10. Hajdu S, Kaltenecker G, Schwendenwein E, Vecsei V. Apophyseal injuries of the proximal tibial tubercle. Int Orthop 2000; 24: 279- 281.