A SIMULTANEOUS ARTHROSCOPIC PULL-OUT SUTURE FIXATION FOR ACL AVULSION WITH DIRECT REPAIR OF PATELLA TENDON AVULSION USING ANCHOR SUTURE IN AN 11-YEARS OLD GIRL – A CASE REPORT

Abstract

Tibial tuberosity avulsion and tibial spine fractures are rare injuries, though they occur more commonly in children and adolescents due to incomplete ossification of the tibial tuberosity and tibial spine, which renders these structures weaker than the attached ligaments and musculature. However, to our knowledge, no case of combined tibial tuberosity avulsion and tibial spine fracture has been reported in the literature, presenting unique diagnostic and surgical challenges. This case report details the presentation, diagnosis, and surgical management of an 11-year-old girl who sustained this unprecedented dual injury following a motor vehicle accident. The surgical approach included the Krackow suture technique of patella tendon with a knotless anchor for tibial tuberosity fixation and an arthroscopic suture pull-out technique with cortical button fixation for the anterior cruciate ligament (ACL) tibial spine fracture. This case underscores the importance of early diagnosis and a tailored surgical approach to ensure optimal outcome.