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Eur J Orthop Surg Traumatol. 2018 Feb;28(2):317-323. doi: 10.1007/s00590-017-2048-z. Epub 2017 Sep 27.

Combined avulsion fracture of the tibial tubercle and patellar tendon rupture in pediatric population: case series and review of literature.

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Department of Orthopaedic Surgery, Texas Children's Hospital, 6701 Fannin St. Suite 660, Houston, TX, 77030, USA.


Simultaneous occurrence of tibial tubercle fracture and patellar tendon avulsion with double-hit injury of the knee extensor mechanism is an extremely rare condition. However, they become more frequent due to increased participation in sports and high-energy recreational activities at younger age. It represents a frequently missed diagnosis; therefore, high index of suspicion is required for the diagnosis of such injuries to avoid delays in the treatment which would lead to possible suboptimal functional outcome. Only few case reports of such injuries were reported in the literature with limited information regarding frequency, diagnosis, and outcome in children. To the best of our knowledge, this is the first case series with such type of injury.


Double-hit injuries; Knee extensor mechanism injury; Knee injuries

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