Tibial eminence fractures are uncommon injuries. The condition affects children and adolescents more than adults. Subchondral weakness in the pediatric population causes the anterior cruciate ligament (ACL) insertion site to break.
Considered an ACL injury-equivalent in children, this fracture pattern was first described by Poncet in 1875. The anatomic structure primarily involves the tibial eminence, a nonarticular region located between the condylar surfaces of the tibial plateaus. The ACL inserts 10 to 14 mm posterior to the anterior tibial border and is deeply attached to the subchondral plate. Tibial eminence injury may cause the knee to lose biomechanical function and stability.
As the fracture is an ACL injury-equivalent, this condition can involve neighboring ligaments. The anterior horn of the medial and lateral menisci and the intermeniscal ligament lie anterior to the tibial eminence. Disruption of the tibial eminence can easily entrap these structures when the fracture fragment elevates superiorly.
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