Sports Medicine: Tibial Spine Fracture
What is a tibial spine fracture?
The tibial spine is a boney ridge in the middle of the tibial plateau (the flat upper portion of the tibia on which the femur rests). The anterior cruciate ligament (ACL) attaches to the front of this prominence. A tibial spine fracture occurs when stress is placed on the ACL pulling a portion or the entire tibial spine away from the rest of the tibia.
What causes a tibial spine fracture?
A tibial spine fracture usually occurs in athletes whose bones are not done growing. This happens when the leg is forcefully straightened and twisted outward or flexed excessively. The force causes the ACL to pull the tibial spine away from the tibia. In an older athlete, this force would often tear the ACL, but in a young athlete the ACL is actually stronger than the immature bone, so the tibial spine is fractured.
What are the symptoms of a tibial spine fracture?
Symptoms of a tibial spine fracture are similar to the symptoms of an ACL tear. The athlete will often feel significant pain that can be accompanied by a “popping” sensation. A tibial spine fracture usually causes the knee to swell significantly and the athlete may be reluctant to put weight on the leg. In some cases the athlete will be unable to fully straighten or bend their leg due to pain or the fractured piece of bone blocking movement.
How is a tibial spine fracture diagnosed?
After a history and physical exam, the physician will need to order x-rays. The physical tests and symptoms are similar to an ACL tear, so the only way to determine if there has been a tibial spine fracture is to order x-rays. The physician may also order an MRI to determine if the ACL or other aspects of the knee sustained any damage during the injury.
What is the treatment for a tibial spine fracture?
If the fracture is not completely separated from the tibia, the physician will make sure that the fracture is lined up correctly. Once this is done, they will put the leg in a full length cast with the knee almost completely straight. If the tibial spine fracture is separated from the tibia, surgery will be required to allow complete healing.
What is the long term outlook for a tibial spine fracture?
With proper treatment and rehabilitation, most young athletes fully recover from a tibial spine fracture.
