Osteogenesis imperfecta presenting as simultaneous bilateral tibial tubercle avulsion fractures in a child: a case report.

This is a case report of a unique presentation of a mild form of osteogenesis imperfecta (OI) (type IA) in a 9-year-old African-American boy who presented with simultaneous bilateral tibial tubercle avulsion fractures. The boy presented to the authors' emergency room complaining of acute bilateral knee pain. He could not perform a straight leg raise. Other than his orthopaedic examination, significant findings included blue sclera and irregular teeth. Radiographs and magnetic resonance imaging (MRI) confirmed bilateral tibia tubercle avulsion fractures. The patient underwent open reduction and internal fixation of his fractures, and postoperative genetic testing confirmed that the patient was heterozygous for OI. The authors present the fourth reported case of simultaneous bilateral tibial tubercle fractures. To their knowledge this is the first case of OI presenting with these fractures, the youngest reported case, and the first case with MRI documentation.

Primary Treatment of Ankle Trauma.

In brief Decreasing inflammation and pain associated with an ankle injury is the first goal of treatment. Then success depends on accurately assessing the extent of the injury. With sprains and strains, options include bracing, taping, and range-of-motion exercises. For fractures, the key is knowing when to treat conservatively and when to refer. With any ankle injury, aggressive rehabilitation often produces good results.