Tibial Spine Fracture and Physical Therapy Protocol

Introduction

Tibial spine fracture (also called Tibial Eminence Fracture) is a break at the top of the tibia bone in the lower leg near the knee as a result of high amounts of tension placed upon the anterior cruciate ligament (ACL). This type of injury is most common in

1) children ages 8 to 14 years of age.

2) The incidence of these fractures is higher among adolescent girls due to their inherent skeletal immaturity.

3) It has also been proposed that injury occurs secondary to greater elasticity of ligaments in young people .

4) It can occur during a sporting event or direct trauma with a hyperextension injury causes an avulsion fracture occurring at the tibial eminence while the ACL is spared.

This type of force causes the ACL to pull on the tibial spine. Because the bones of children this age still have open growth plates, the ACL is stronger than the tibial spine and can pull away from the bone (avulse), causing a fracture.

One of the most widely used classification methods for a tibial eminence fracture is Meyers and McKeever’s categorization, which delineates different displacement levels of avulsion as well as different management strategies