Avulsion of the apophysis

Avulsion of the tibial apophysis is classified as 41t-M/7.

These injuries are an avulsion of the tibial apophysis by the patellar tendon.

Avulsion of the tibial apophysis usually occurs in adolescents who are approaching skeletal maturity.

There is a potential for growth disturbance, which is particularly relevant in younger patients.

The tibial tubercle is cartilaginous in young children. The apophysis appears in the age range of 11–14 years and fuses with the proximal tibial epiphysis between 14 and 18 years.

Avulsion of the apophysis is typically seen in adolescents around the time of physeal closure.

The amount of displacement and size of avulsed fragment depends on the energy of injury.

The majority of these fractures are displaced due to the force of the quadriceps through the patellar tendon.

There is a risk of anterior growth arrest leading to an apex posterior (extension) deformity, particularly in younger patients.

This fracture is usually accompanied with a large soft-tissue injury.

These injuries are occasionally associated with compartment syndrome and frequent clinical assessment is mandatory in the early period following the injury.

Extraarticular apophyseal avulsion fracture

Intraarticular apophyseal avulsion fracture