Avulsion fractures of the tibial tuberosity in adolescents treated by tension band wiring

This study deals with the surgical treatment and the results of 7 avulsion fractures of the tibial tuberosity in adolescents. All the patients were treated in our department from 1977 to 1989. These are mainly athletic injuries accounting for less than 3% of all epiphyseal bones and they have not been widely reported in the orthopaedic literature. It is a different entity from Osgood Schlatter disease which is noted as a predisposing factor. The mechanism of injury consists of sudden, unexpected contraction in the quadriceps while the knee is being forcibly flexed. The closing physis of the tuberosity cannot resist the increased tensile forces and it is avulsed. Operative treatment was thought necessary for all our cases due to tibial tuberosity displacement and open reduction, internal fixation with tension-band technique was used. This lessens the need for immobilization at the joint following surgery.Functional results were very good and all the patients returned to their previous athletic activities.