Nonunion after avulsion fracture of the anterior tibial spine

Nonunion of an avulsion fracture of the anterior tibial spine is quite rare. It could be associated with significant instability of the knee as it involves the fixation of the anterior cruciate ligament. Some of the complications of this nonunion include pain in knee extension, loss of knee extension and a certain amount of anterior knee instability. So, loss of knee extension is often a direct result of the nonunion of the displaced fragment. The purpose of this report was to present a case of 14-year-old girl suffering a nonunion anterior spine avulsion fracture. The patient complained of persistent knee pain and loss of knee extension. Plain radiographs, computed tomography (CT) scans and magnetic resonance imaging (MRI) were carried out, which revealed a nonunion after avulsion fracture of the anterior tibial spine. The patient was treated by arthroscopic excision of the bony prominence. A final postoperative follow-up of 6 years and 11 months post-surgery, the patient had fully recovered and presented a normal function of the affected knee that she was able to return to sports without any symptoms.