A "Suture Staple" Knotless Anchor Technique for Fixation of Tibial Tubercle Avulsion Fractures in Pediatric Patients

Tibial tubercle fractures are rare injuries most commonly seen in the pediatric population; more specifically the adolescent male population towards the end of peak longitudinal growth. Typically, tibial tubercle fractures are fixed with cannulated screws. However, there is a subsection of patients with tibial tubercle avulsion fractures in which the fracture fragment is small and attempts at screw fixation may lead to screw cut-out and fragment damage. To address this, we describe a technique for small or thin tibial tubercle fractures using a tensionable knotless anchor construct with 2-4 independent mattress sutures placed in a staple configuration. This method employs the biomechanical strength of knotless fixation while eliminating the potential single point of failure and hardware prominence seen with screws and knotted anchors.