Tibial Eminence (Spine) Fracture

A tibial eminence fracture is a partial or complete fracture of the attachment of the anterior cruciate ligament (ACL), one of the four major ligaments of the knee. The ACL is a ropelike structure that helps keep the normal relationship of the femur (thigh bone) and the tibia (leg bone). This ligament is most important in sports that require pivoting, changing direction (cutting), or jumping and landing. In children, the bony attachment of the ACL is more likely to break off (fracture) than in adults. However, this ligament is often stretched in conjunction with the bone pulling off the leg bone (tibia). Associated injuries to the collateral ligaments (on either side of the knee) or the meniscus cartilage can occur often with this injury.

Initial treatment consists of medications and ice to relieve pain and reduce the swelling of the knee. If the bone is in the proper position or can be positioned without surgery, immobilization with a brace or cast for four to six weeks is recommended. Crutches may be recommended for walking. If the bones are not in proper position, surgery is usually needed to reposition the bones and hold them with sutures, wires, or screws. After immobilization (with or without surgery), stretching and strengthening of the injured and weakened joint and surrounding muscles (due to the injury and the immobilization) are necessary. These may be done with or without the assistance of a physical therapist or athletic trainer. The sutures, wires, or screws usually do not need to be removed.