The tibial spine is located at the top front area of the shinbone (tibia) near the knee. In adults, the tibial spine is hardened bone, but in kids who haven't finished growing, it's soft and more prone to injury. Tibial spine avulsion is a break, or fracture, of this area of the shinbone. Common causes include sports injuries, falls, and motor vehicle accidents.

Symptoms of tibial spine avulsion can include pain, swelling, and the inability to completely bend the knee.  Depending on the severity of the fracture, tibial spine avulsion may be treated with a cast or surgery,  followed by physical therapy.

• Your child should use crutches as instructed and stay off the leg until the health care provider says it's OK.
• Your child should wear the knee brace or immobilizer provided by the health care provider at all times.
• If your health care provider recommended it, give your child ibuprofen or naproxen as needed for discomfort. Follow the dosage instructions given by the health care provider.
• If your child's knee is swollen, you can apply ice up to every 2 hours while your child is awake. Place the ice in a plastic bag, wrap the bag in a cloth, and hold it to the injured knee for up to 20 minutes at a time. Do not apply ice directly to skin.
• Also reduce swelling by using pillows to elevate the knee when your child is sitting or lying down.

• If you haven't already done so, make a follow-up appointment with the orthopedic surgeon.

• The pain worsens despite pain medication.
• Your child's knee becomes very swollen.