Trifocal Injury of the Patellar Tendon- An Exceedingly Rare Case Report.

Area of Science:

• Orthopedic surgery
• Sports medicine
• Pediatric orthopedics

Background:

• Patellar tendon injuries are common, often presenting as bifocal avulsion fractures.
• Previous literature has not documented trifocal patellar tendon injuries.

Observation:

• A novel case of a trifocal patellar tendon injury is presented.
• The injury involved distal pole of patella avulsion fracture, tibial tuberosity avulsion, and an osteochondral lateral patella facet fracture with a longitudinal patellar tendon split.

Findings:

• The adolescent patient underwent successful surgical fixation using transosseous pull-through sutures, suture tape, and a knotless anchor.
• The fixation method avoided the physis, crucial for immature skeletons.
• The patient achieved full knee range of motion after rehabilitation.

Implications:

• This case highlights a previously undocumented trifocal patellar tendon injury pattern.
• Suture-based fixation techniques offer a flexible and effective alternative to traditional screw fixation for pediatric patellar tendon injuries.
• The findings suggest that advanced suture techniques can provide adequate strength and promote favorable outcomes in complex pediatric tendon injuries.