Leg/Knee Case 11 Background

Medial Tibial Eminence (Spine) Fracture

The tibial intercondylar eminence is a bony prominence of the tibia between the medial and lateral tibial plateaus. This eminence consists of a medial and lateral spine, and anterior and posterior recesses that house the bony insertion sites of the cruciate ligaments and menisci. The anterior cruciate ligament (ACL) attaches to the medial spine of the tibial eminence. A tibial eminence fracture occurs with bony avulsion of the ACL from its insertion site on the medial spine.

This fracture is primarily seen in the pediatric population ages 8 to 14 years old, when the eminence is incompletely ossified and more prone to failure than the ligament itself.  In skeletally mature adults, the injury can be seen in high-speed road accidents such as biking collisions or motor vehicle collisions. Up to 40% of tibial eminence fractures include concurrent injuries to the meniscus, collateral ligaments, and osteochondral structures.