

The tibial eminence is also referred to as the tibial spine. The tibia is the name of the shin bone in your lower leg. At the top of this bone is located a protrusion where the anterior cruciate ligament attaches inferiorly. In anatomy, bony protrusions are referred to as ‘spines’ and serve as a landmark to help identify different parts of a bone. Tibial spine fractures are more common in the pediatric population. It is a common result of a sports-related activity. In an adult, a similar injury may cause an ACL tear. However, in a child, when injury occurs that forces the leg into extreme hyperextension, the ACL will usually remain intact and instead of tearing will pull off a piece of bone from its attachment site. That’s what an avulsion fracture is, when a piece of bone is broken off the bone by a ligament. This is because of bones that are not fully developed yet. There are different types of avulsion fractures depending on the severity and if the bone fracture is displaced. The classifications are based on the widely accepted Meyers and McKeever Classification System:
An avulsion fracture is the result of the body being forced into an unnatural position, causing a ligament to strain. But, instead of this strain causing the ligament to tear, it instead remains intact and pulls off a piece of bone where it attaches. Avulsion fractures are much more common in children, and rare in adults. In adults, the same injury may cause an ACL tear rather than a tibial spine avulsion fracture. The causes of an avulsion fracture will be a traumatic event, usually forcing the leg into a position hypertension, but interestingly has been found in children to be a result of forced flexion along with internal rotation. The causes of these fractures are nearly always sporting or activity related or may include:
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The symptoms of an avulsion fracture are similar to other acute orthopedic injuries and is the reason that an accurate diagnosis is so important using either an x-ray, CT scan, MRI, or all three. Avulsion fractures are commonly associated with other injuries so a thorough evaluation of the entire knee joint is vital. The symptoms that may be experienced after an avulsion fracture are:
Prompt medical attention is imperative or you risk inadequate healing of the bone or bone healing in an incorrect position.
Prevention of an avulsion fracture is a matter of prevention of injury, since this condition is caused by traumatic events. However, along with injury prevention, there are steps to take in order to strengthen bones and ligaments so that they are able to withstand greater forces and you lessen the risk of any injury or accident causing devastating damage. These are: