The cases of fourteen adolescents with fifteen physeal fractures of the
tibial tuberosity were reviewed to more accurately define specific fracture
patterns, to establish treatment for the different types, and to determine
the incidence of complications. A modified classification scheme with a
greater emphasis on intra-articular extension of the fracture and
communution of the tuberosity was devised. Closed or open reduction, as
necessary, gave satisfactory results. The primary indications for surgery
were: (1) displacement of one or more fragments of the tuberosity
anterosuperiorly, and (2) extension of the fracture through the proximal
tibial ossification center into the knee joint, with disruption of the
joint surface. There appears to be an increased incidence of pre-existing
Osgood-Schlatter disease (ipsilateral and contralateral) in patients who
have an acute tuberosity injury. Complications are rare. The theoretical
possibility of the subsequent development of genu recurvatum appears
unlikely, since most of these injuries occur when the physis of the
tuberosity is undergoing normal closure.