Simultaneous Bilateral Tibial Tubercle Avulsion Fractures Complicated by Compartment Syndrome in an Adolescent With Osteogenesis Imperfecta: A Case Report.

BACKGROUND: Osteogenesis imperfecta (OI) is a rare collagen disorder causing brittle bones. Tibial tubercle fractures are uncommon in children, comprising < 2.7% of pediatric fractures, and bilateral injuries in OI are exceptionally rare. No prior reports detail bilateral tibial tubercle fractures with concurrent bilateral compartment syndrome. We present the first known case of this presentation in an 11-year-old boy. CASE PRESENTATION: An 11-year-old male with OI fell on his knees, presenting with severe bilateral leg pain. Imaging revealed bilateral Ogden III tibial tubercle fractures. Due to tense compartments, emergent fasciotomies were performed, followed by open reduction and internal fixation. At 16-month follow-up, the patient reported no complications and demonstrated normal ambulation. CONCLUSION: Surgeons should maintain a high index of suspicion for compartment syndrome in patients with OI presenting with tibial tubercle fractures, including after low-energy mechanisms, and intervene promptly when clinically indicated.