{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T01:08:54Z","timestamp":1789002534349,"version":"build-2803163510"},"reference-count":48,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:00:00Z","timestamp":1741737600000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Discovery"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Tibial tubercle avulsion fractures (TTAFs) are uncommon injuries in the pediatric population, predominantly affecting children and adolescents who are approaching skeletal maturity and frequently engage in high\u2010energy activities. Despite of their rarity, TTAFs can significantly impact the lives of young individuals involved in sports and other strenuous activities. The mechanism of TTAFs occurrence involves forceful quadriceps contraction against resistance or rapid knee flexion with contracted quadriceps. TTAFs may coincide with other related injuries due to their mechanism of occurrence and commonly present with an abrupt onset of pain, focal soft\u2010tissue swelling and tenderness on palpation. Predisposing factors such as a history of Osgood\u2010Schlatter disease and an extreme body mass index (BMI) could contribute to TTAFs susceptibility. Diagnosis of TTAFs typically relies on X\u2010rays, complemented by computed tomography (CT) and magnetic resonance imaging (MRI) for screening associated injuries and preoperative assessment. While a well\u2010established classification system exists, with the Ogden classification being the most commonly employed, intriguingly, a direct correlation between fracture type and treatment method, as well as the choice of surgical fixation modality, remains elusive. The management of TTAFs encompasses both conservative and surgical approaches, with open reduction internal fixation (ORIF) being the predominant surgical method and the prognosis for this condition is generally favorable. By synthesizing existing knowledge and presenting potential areas of uncertainty, this review aims to offer valuable insights to orthopedic practitioners when they are confronted with this infrequent injury.<\/jats:p>","DOI":"10.1002\/pdi3.2521","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T18:58:52Z","timestamp":1741805932000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Tibial tubercle avulsion fractures in children and adolescents"],"prefix":"10.1002","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8024-7629","authenticated-orcid":false,"given":"Hailun","family":"Yao","sequence":"first","affiliation":[{"name":"Department of Orthopedics Ministry of Education Key Laboratory of Child Development and Disorders National Clinical Research Center for Child Health and Disorders China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics Children's Hospital of Chongqing Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanlin","family":"He","sequence":"additional","affiliation":[{"name":"West China School of Medicine Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0987-289X","authenticated-orcid":false,"given":"Xiang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Ministry of Education Key Laboratory of Child Development and Disorders National Clinical Research Center for Child Health and Disorders China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics Children's Hospital of Chongqing Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingyan","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Ministry of Education Key Laboratory of Child Development and Disorders National Clinical Research Center for Child Health and Disorders China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics Children's Hospital of Chongqing Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peikang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Ministry of Education Key Laboratory of Child Development and Disorders National Clinical Research Center for Child Health and Disorders China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics Children's Hospital of Chongqing Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1174-3881","authenticated-orcid":false,"given":"Man","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Ministry of Education Key Laboratory of Child Development and Disorders National Clinical Research Center for Child Health and Disorders China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics Children's Hospital of Chongqing Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6306-7803","authenticated-orcid":false,"given":"Xinkai","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Ministry of Education Key Laboratory of Child Development and Disorders National Clinical Research Center for Child Health and Disorders China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics Children's Hospital of Chongqing Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xing","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Ministry of Education Key Laboratory of Child Development and Disorders National Clinical Research Center for Child Health and Disorders China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics Children's Hospital of Chongqing Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,12]]},"reference":[{"key":"e_1_2_17_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2006.04.008"},{"key":"e_1_2_17_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-198603000-00013"},{"key":"e_1_2_17_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-016-9370-7"},{"key":"e_1_2_17_5_1","doi-asserted-by":"publisher","DOI":"10.2340\/17453674.2022.4879"},{"key":"e_1_2_17_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPB.0000000000000313"},{"key":"e_1_2_17_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000000488"},{"key":"e_1_2_17_8_1","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-15-00328"},{"key":"e_1_2_17_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-008-0628-4"},{"key":"e_1_2_17_10_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.RVW.19.00186"},{"key":"e_1_2_17_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPB.0000000000000756"},{"key":"e_1_2_17_12_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1625955"},{"key":"e_1_2_17_13_1","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/5925421"},{"key":"e_1_2_17_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11832-008-0131-z"},{"key":"e_1_2_17_15_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.CC.M.00208"},{"issue":"1","key":"e_1_2_17_16_1","first-page":"153","article-title":"The pediatric knee and proximal Tibia","volume":"67","author":"Woernle M","year":"2020","journal-title":"Pediatr Clin"},{"key":"e_1_2_17_17_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198062020-00006"},{"key":"e_1_2_17_18_1","first-page":"180","article-title":"Osgood\u2010Schlatter\u2019s disease and tibial tuberosity development","volume":"116","author":"Ogden JA","year":"1976","journal-title":"Clin Orthop Relat Res"},{"key":"e_1_2_17_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2019.10.012"},{"key":"e_1_2_17_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-019-02390-x"},{"key":"e_1_2_17_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000001818"},{"key":"e_1_2_17_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jos.2021.06.002"},{"key":"e_1_2_17_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000016700"},{"key":"e_1_2_17_24_1","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/8535370"},{"key":"e_1_2_17_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/80.2.514"},{"key":"e_1_2_17_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2014.04.006"},{"key":"e_1_2_17_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000001087"},{"key":"e_1_2_17_28_1","first-page":"491","article-title":"The insertion of the ligamentum patellae on the tibial tuberosity. Some views in connection with the Osgood\u2010Schlatter lesion","volume":"121","author":"Ehrenborg G","year":"1961","journal-title":"Acta Chir Scand"},{"key":"e_1_2_17_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-5898(02)00061-5"},{"issue":"177","key":"e_1_2_17_30_1","first-page":"188","article-title":"Ligament injuries associated with physeal fractures about the knee","volume":"177","author":"Bertin KC","year":"1983","journal-title":"Clin Orthop Relat Res"},{"key":"e_1_2_17_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199310000-00030"},{"key":"e_1_2_17_32_1","doi-asserted-by":"publisher","DOI":"10.1302\/2058-5241.5.190026"},{"key":"e_1_2_17_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-197411000-00002"},{"issue":"194","key":"e_1_2_17_34_1","first-page":"181","article-title":"An unusual avulsion fracture of the proximal tibial epiphysis. Case report and proposed addition to the Watson\u2010Jones classification","volume":"194","author":"Ryu RK","year":"1985","journal-title":"Clin Orthop Relat Res"},{"key":"e_1_2_17_35_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199072090-00024"},{"key":"e_1_2_17_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0b013e318271bb05"},{"key":"e_1_2_17_37_1","doi-asserted-by":"publisher","DOI":"10.1302\/1863-2548.15.210117"},{"key":"e_1_2_17_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPB.0000000000000919"},{"key":"e_1_2_17_39_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.72B2.2312561"},{"key":"e_1_2_17_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0000000000000870"},{"key":"e_1_2_17_41_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.ST.19.00062"},{"key":"e_1_2_17_42_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1262318"},{"key":"e_1_2_17_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000001269"},{"key":"e_1_2_17_44_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000002208"},{"key":"e_1_2_17_45_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11832-011-0369-8"},{"key":"e_1_2_17_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2020.10.072"},{"key":"e_1_2_17_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2019.12.033"},{"key":"e_1_2_17_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2012.06.025"},{"key":"e_1_2_17_49_1","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/952978"}],"container-title":["Pediatric Discovery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pdi3.2521","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T21:09:44Z","timestamp":1743455384000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pdi3.2521"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":48,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1002\/pdi3.2521"],"URL":"https:\/\/doi.org\/10.1002\/pdi3.2521","archive":["Portico"],"relation":{},"ISSN":["2835-558X","2835-5598"],"issn-type":[{"value":"2835-558X","type":"print"},{"value":"2835-5598","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3]]},"assertion":[{"value":"2023-03-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e2521"}}