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Case Reports
. 2021 Feb 20:32:100440.
doi: 10.1016/j.tcr.2021.100440. eCollection 2021 Apr.

Fracture of tibial tuberosity in an adult with Paget's disease of the bone - An interesting case and review of literature

Marjan Raad  1 , Sebastian Ndlovu  1 , Tord Hǿgsand  1 , Saif Ahmed  1 , Mark Norris  1
Affiliations
Case Reports

Fracture of tibial tuberosity in an adult with Paget's disease of the bone - An interesting case and review of literature

Marjan Raad et al. Trauma Case Rep. .

Erratum in

Abstract

Introduction: Paget's disease of the bone is a non-malignant skeletal disorder characterized by focal abnormalities in bone remodelling at one or more skeletal sites. Pathological fractures occurring from trivial injuries are a well-known clinical presentation in patients with Paget's disease. An avulsion fracture of the tibial tuberosity is an infrequent injury and has an extremely low occurrence in adults, with only a few cases reported in literature. We describe a case of a patient with undiagnosed Paget's Disease of the bone, sustaining a pathological avulsion fracture of the tibial tuberosity.

Case report: A 54-year-old male presented with right knee pain after his knee gave way whilst standing in the goal area during a game of football, twisting his right ankle and falling. Plain radiographs of the knee revealed an avulsion fracture of the tibial tuberosity with abnormal modelling of the proximal half of the tibia. An MRI confirmed a diagnosis of Paget's disease of the bone. The patient underwent open reduction internal fixation. At 3 months follow up, the patient had good knee range of motion from 0 to 100 degrees and by 6 months he had returned to his usual activities.

Conclusion: We describe a unique case of tibial tuberosity avulsion fracture in an adult with PDB. Treatment was successful with cannulated screws and tension band wiring. Patients with PDB who fracture present with diagnostic and operative challenges, it is vital to progress with caution in the postoperative rehabilitation phase.

Keywords: Adult fracture; Bone fragility; Paget's disease of the bone; Tibial tuberosity fracture.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1.
Right knee AP radiograph showing avulsion fracture of the tibial tuberosity.
Fig. 2
Fig. 2.
Right knee lateral radiograph showing avulsion fracture of the tibial tuberosity.
Fig. 3
Fig. 3.
MRI scan revealing marked Paget’s disease of the proximal tibia.
Fig. 4
Fig. 4.
MRI scan revealing marked Paget’s disease of the proximal tibia.
Fig. 5
Fig. 5.
Right knee lateral radiograph from five years ago revealing similar picture to Figure 1.
Fig. 6
Fig. 6.
AP radiograph of the knee taken three weeks postoperatively showing fixation with cannulated screws and tension band wire.
Fig. 7
Fig. 7.
Lateral radiograph of the knee taken postoperatively.
See this image and copyright information in PMC

References

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