Bilateral Proximal Tibial Sleeve Fractures in a Child: A Case Report

Authors

Department of Trauma and Orthopaedics, Queen’s Hospital Romford, Rom Valley Way, Romford, Essex RM7 0AG, UK

10.5812/atr.27898

Abstract

Introduction
A sleeve fracture classically describes an avulsion of cartilage or periosteum with or without osseous fragments and usually occurs at the inferior margin of the patella. Tibial tubercle sleeve fractures in the skeletally immature are extremely rare.


Case Presentation
In this report the authors describe a 12-year-old boy with no systemic disease and no steroid use who sustained bilateral proximal tibial sleeve fractures whilst playing football. Both ruptures were associated with rupture of the medial patellofemoral ligament and tear of the medial retinaculum. Treatment was performed with primary end-to-end repair, reinforcement with bone anchors and cerclage wires with an excellent outcome.


Conclusions
We feel this rare, currently unclassified variant of a tibial tubercle avulsion fracture should be recognised and consideration taken to adding it to existing classification systems.

Keywords