Proximal tibia triplane fracture with apophyseal avulsion.

Area of Science:

• Orthopedic surgery
• Pediatric orthopedics
• Sports medicine

Background:

• Tibial tuberosity fractures are rare in children, accounting for less than 1% of all pediatric fractures.
• Proximal tibial triplane fractures are also uncommon, with limited cases reported in medical literature.

Observation:

• An early adolescent football player sustained an injury during a tackle.
• Computed tomography (CT) revealed a concurrent tibial apophyseal fracture and a proximal tibial triplane fracture.

Findings:

• The patient underwent successful operative reduction using cancellous cannulated screws.
• This case represents one of only 11 reported instances of proximal tibial triplane fractures.
• Two other reported cases of concurrent tibial tuberosity and triplane fractures occurred in football players.

Implications:

• The authors propose that the combination of forced knee flexion and rotation, common in football, may contribute to this rare fracture pattern.
• This case highlights a potential mechanism for combined tibial fractures in adolescent athletes.
• Understanding this mechanism can inform future management and prevention strategies for similar injuries.