A Surgical Technique for Tibial Tubercle Avulsion Fractures Using Transpatellar Suture Tape Tension Band and De-tensioning Suture Anchors

This article aims to present a comprehensive technical note detailing our preferred treatment approach for tibial tuberosity avulsion fractures in the adult and elderly populations, particularly in scenarios characterized by low tissue quality and limited bone stock. Existing literature on this fracture type is scarce, with many described techniques relying on optimal bone quality for effective screw fixation of the tibial tuberosity. Various methods for tibial tuberosity avulsion fixation include K-wires, cannulated screws, staples, tension bands, suture anchors, and in select cases, direct transosseous sutures. Our technique focuses on robustly supporting the extensor mechanism through a synergistic combination of de-tensioning suture anchors, tension band suture taping, and suture augmentation of the patellar tendon. This approach addresses the challenges posed by compromised tissue quality and limited bone stock, offering a valuable contribution to the management of these fractures.