This fracture may also be caused by overuse, such as distance running, endurance activities, and repetitive impact activities – typically, these would be stress fractures in the proximal tibial location.
Proximal tibia fractures can also be associated with pathologic fractures secondary to cancer, infection, or metabolic deficiency.
Typical injury mechanisms: Proximal tibial fractures can occur with low- or high-impact injuries.
Low energy –
- Torque along with indirect impact to the bone can cause a spiral fracture with minimal soft tissue injury.
- Direct impact leads to wedge / small oblique fractures along with significant comminution of the proximal tibia.
- Associated injuries: Soft tissue injury, compartment syndrome, bone loss, and ipsilateral-skeletal injury can occur as a result of this type of high-energy injury.
Prevalence: In general, high-energy injuries are more likely to occur in younger male patients, while low-energy injuries resulting in a proximal tibia fracture tend to occur in older female patients.
Risk factors:
- Cancer
- Infection
- Osteoporosis
- High-energy injury mechanisms
- High-energy trauma leading to wedge / small oblique fractures with significant comminution of the proximal tibia.
- Low-energy trauma with an indirect impact to the bone resulting in a spiral fracture with minimal soft tissue injury.