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Proximal tibia triplane fracture with apophyseal avulsion
  1. Benjamin Lin,
  2. Haider Twaij,
  3. Mohammed Monem and
  4. Khaled M Sarraf
  1. Trauma & Orthopaedics, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
  1. Correspondence to Benjamin Lin; benjaminlin25{at}


Tibial tuberosity fractures occur in fewer than 1% of all paediatric fractures. We present this unusual case of an early adolescent football player who presented to the emergency department after sustaining an injury during a tackle. CT confirmed a tibial apophyseal fracture concurrent with a proximal tibial triplane fracture. The fracture was subsequently reduced operatively with cancellous cannulated screws. There are only 11 cases published in the literature of triplane fractures of the proximal tibia. Both other cases that involve a concurrent tibial tuberosity fracture with a triplane extension were sustained following a footballing injury. We therefore propose that forced knee flexion alongside a rotational component, common to football, may promote this rare fracture pattern. It is hoped that this case can be used to shed light on a possible mechanism and to guide future management.

  • Orthopaedics
  • Paediatrics
  • Knee injuries
  • Surgery

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  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: BL, HT, MM and KMS. Supervised by KMS. Patient under the care of KMS and clinical care provided by all authors BL, HT, MM and KMS. Article written by BL. Drafts checked and amended by HT, MM and KMS. The following authors gave final approval of the manuscript: BL, HT, MM and KMS.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.