Proximal tibia triplane fracture with apophyseal avulsion

Tibial tuberosity fractures occur in fewer than 1% of all paediatric fractures. We present this unusual case of an early adolescent football player who presented to the emergency department after sustaining an injury during a tackle. CT confirmed a tibial apophyseal fracture concurrent with a proximal tibial triplane fracture. The fracture was subsequently reduced operatively with cancellous cannulated screws. There are only 11 cases published in the literature of triplane fractures of the proximal tibia. Both other cases that involve a concurrent tibial tuberosity fracture with a triplane extension were sustained following a footballing injury. We therefore propose that forced knee flexion alongside a rotational component, common to football, may promote this rare fracture pattern. It is hoped that this case can be used to shed light on a possible mechanism and to guide future management.