Avulsion fractures of the tibial tubercle in adolescent athletes are uncommon injuries, believed to be a result of forceful extension of the knee against a fixed leg. Concomitant injury to the ipsilateral patella tendon is even more rare, with few cases reported in the literature. The mechanisms responsible for this association are not well understood. The significance of this double insult to the knee extensor mechanism is the potential deleterious effect of misdiagnosis and/or mismanagement. In this case report, the pathophysiology, mechanism of injury, classification, diagnosis, and management of concomitant injury are reviewed. [Orthopedics. 2016; 39(3):e561-e564.].

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