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. 2007 Jun;51(2):99-105.

Rehabilitation of tibial eminence fracture

Roya Salehoun  1 , Nima Pardisnia
Affiliations

Rehabilitation of tibial eminence fracture

Roya Salehoun et al. J Can Chiropr Assoc. 2007 Jun.

Abstract
in English, French

Tibial eminence fractures occur as a result of high amounts of tension placed upon the anterior cruciate ligament (ACL). The incidence of these fractures is higher among adolescent girls due to their inherent skeletal immaturity. In such an injury, direct trauma causes an avulsion fracture occurring at the tibial eminence while the ACL is spared. Imaging is used to confirm the diagnosis of a tibial eminence fracture and regardless of the extent of injury, rehabilitation is crucial for a full recovery. The following is a case study of a 17-year-old girl who was involved in a motor vehicle accident. In the accident, she sustained a left lateral tibial eminence fracture, along with soft tissue injuries at the cervical and lumbar spine. Her treatment included passive and active range of motion (ROM), strength training, physical modalities, and proprioceptive training of the injured areas. An improvement was noted post-treatment and after a 5-month follow-up according to subjective reports and objective assessments (ROM and girth measurements).

Une fracture de l’éminence du tibia se produit quand une tension excessive est placée sur le ligament croisé antérieur du genou. L’incidence de ces fractures est plus fréquente chez les jeunes adolescentes en raison de l’immaturité inhérente du squelette. Lors d’une telle blessure, un trauma direct cause une avulsion-fracture qui se loge dans l’éminence du tibia alors que le ligament croisé antérieur du genou est épargné. On utilise l’imagerie médicale pour confirmer le diagnostic de la fracture de l’éminence du tibia et, peu importe la gravité de la blessure, la réadaptation est essentielle pour un rétablissement complet. Voilà une étude de cas d’une jeune fille de 17 ans impliquée dans un accident de motocyclette. Dans l’accident, elle a subi une fracture de l’éminence du tibia du côté gauche, en plus de meurtrissures aux tissus mous au niveau cervical et lombaire. Son traitement a consisté en amplitude de mouvements passifs et actifs, l’entraînement musculaire, la modalité physique, un entraînement proprioceptif des parties blessées. On a observé une amélioration après les traitements et après un suivi à cinq mois selon les rapports subjectifs et les évaluations objectives (amplitudes de mouvement et mesures des circonférences).

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Figures

Figure 1
Figure 1
Dashed area depicts avulsion fracture of ACL. LM, lateral meniscus; MM, medial meniscus; PCL, cut posterior cruciate ligament.
Figure 2
Figure 2
Meyers and McKeever classification of tibial eminence fracture. Type I, with minimal displacement. Type II, anterior third or half of ACL insertion is hinged posteriorly. Type III, complete separation.
Figure 3
Figure 3
Close chain wall squats followed by open chain quadriceps and hamstring training. Advancing from 5 lbs in lying to 10 lbs in standing.
Figure 4
Figure 4
Progression of balance training. The patient is put on a rocker board while holding to the wall. In following visits the patient is asked to move away from the wall and balance with one leg only. Balance sandals and ball tossing is later introduced. A half ball can also be used for balance training.
See this image and copyright information in PMC

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