Proximal Tibia Fractures

Proximal tibia fractures in children pose challenges in management due to the complex anatomy in this region. The relationship between the proximal tibial physis, proximal tibial apophysis, extensor mechanism, and nearby vascular structures allows for potential injuries from toddler-aged children through adolescence. The most common injuries include tibial tubercle fractures, proximal tibia physeal fractures, and proximal tibia metaphyseal fractures; they may result from both low-energy and high-energy mechanisms. Nonoperative treatment is indicated for nondisplaced or adequately reduced fractures, while operative treatment is indicated for irreducible fractures or fractures with loss of adequate reduction. Complications of these injuries may include growth arrest, limb length discrepancy, angular deformity, vascular compromise, and compartment syndrome.