A novel technique of tibial tuberosity fracture fixation with two knotless suture anchors in an adult: A case report and literature review

Abstract

Tibial tuberosity fractures are uncommon in adults. Surgery for these types of fractures is performed similarly to that of tibial tuberosity avulsion fractures in adolescents. The most commonly introduced method is to fix the displaced bone fragments using screws or wires and, if necessary, use tension band wiring for augmentation. However, if the bone fragments are too small or severely comminuted, it may be challenging to fix them using the conventional method. In this study, we introduced a fixation method using two knotless suture anchors that could be attempted in such cases. Since this surgical method fixes the bone fragments without direct damage to the bone fragments, it can be used even when the fragments are small or comminuted. This technique achieved a nearly full active range of knee motion without an extension lag at four weeks postoperatively. In addition, there were no complications related to surgery, and a complete bone union was achieved without additional dislocation. Therefore, this surgical method may be a good alternative if a fixation of the fracture is considered problematic by the conventional method.

Classification and Treatment Strategies of Tibial Tubercle Fractures in Adults

“…achieved excellent results by using lag screws for the treatment of tibial tubercle avulsion fractures 20 . Some scholars chose to use sutures or anchors for fixation and have achieved stable results 21‐23 . Conservative treatment can be continued to be chosen when the displacement is small.…”

“… 20 Some scholars chose to use sutures or anchors for fixation and have achieved stable results. 21 , 22 , 23 Conservative treatment can be continued to be chosen when the displacement is small. When the posterior cortex of the tibial plateau is broken and screw fixation is unsuitable, wire strapping of the fracture site can also produce good results.…”

Isolated Avulsion Fracture of the Tibial Tuberosity in an Adult Treated with Suture-Bridge Fixation: A Rare Case and Literature Review

“…Various techniques for surgically treating avulsion fractures of the tibial tuberosity have been reported for individuals across all age groups. The AO Foundation suggests two techniques for fixation of tibial tuberosity fractures [ 8 ]. One technique uses lag screws to secure the main fragment from anterior to posterior direction [ 20 ].…”

“…Though they comprise less than 3% of all physical injuries in children, tibial tuberosity avulsion fractures are exceptionally uncommon among adults, with limited instances documented in published literature [ 1 , 2 , 3 , 4 , 5 , 6 , 7 ]. Tibial tuberosity fractures are mainly treated by two methods: using lag screws to secure the main fragment from anterior to posterior direction and tension band wiring with cerclage wires at the patella tendon insertion site on the tibial tuberosity [ 8 ]. The suture bridge fixation technique was first introduced as an effective method for repairing rotator cuff tears.…”