Abstract
Tibial tuberosity avulsion fractures are rare injuries, most commonly seen in adolescent males during high-energy activities. These fractures are uncommon, specifically in adults, due to the closure of the physis. In particular, skeletally mature female avulsions are rarely reported in the literature. Significant displacement of the tibial tubercle often necessitates surgical management to restore the extensor mechanism and maintain knee stability. In this case report, we present a 21-year-old female who sustained a tibial tuberosity avulsion fracture with an associated patellar tendon rupture, as well as medial and lateral retinacular injuries following a low-energy fall. Surgical management included a double-row repair technique with SwiveLock anchors (Arthrex, Inc., Naples, FL, USA) and an internal brace construct to reconstruct the extensor mechanism. Simultaneous retinacular repairs were performed, and platelet-rich plasma (PRP) was utilized as an adjunct to enhance soft tissue healing. At six months' follow-up, the patient demonstrated excellent functional recovery, returning to sport-specific activities with no extensor lag, a Lysholm Knee score of 95, and an International Knee Documentation Committee (IKDC) score of 92. In this case, a double-row repair with an internal brace construct was utilized to restore the extensor mechanism, complemented by medial and lateral retinacular repair to enhance knee stability. Additionally, PRP was incorporated as an adjunct to support soft tissue healing.