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When the patient was 9 years old, she fell and bruised her left knee. The knee was immobilized for a month in a long cast. When she was 24 years old, she felt severe knee pain and giving way after playing tennis 1 month before her first visit to our hospital. She complained of knee pain, giving way, locking, and 15\u00b0 loss of knee extension. Radiographs showed a large nonunited fragment at the intercondylar eminence of the tibia. She underwent a reattachment surgery. When she was re\u2010evaluated 17 years after surgery, she had no pain, no giving way, no locking, and no loss of knee extension. On physical examination, there was no instability. Plain anteroposterior and lateral radiographs showed a well\u2010united fragment of the anterior tibial spine. In conclusion, the open reduction for knee pain, giving way, locking, and loss of knee extension caused by nonunion of avulsion of the anterior tibial spine yielded satisfactory results. We believe that in cases of nonunited anterior tibial spine fractures it is necessary to attempt to secure the anterior cruciate ligament in an anatomic position.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2005.03.023","type":"journal-article","created":{"date-parts":[[2005,6,6]],"date-time":"2005-06-06T16:57:20Z","timestamp":1118077040000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":15,"title":["Seventeen\u2010Year Follow\u2010up of a Reattachment of a Nonunited Anterior Tibial Spine Avulsion Fracture"],"prefix":"10.1002","volume":"21","author":[{"given":"Kenji","family":"Kawate","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Nara Medical University Kashihara Nara Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiyuki","family":"Fujisawa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Nara Medical University Kashihara Nara Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Yajima","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Nara Medical University Kashihara Nara Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuya","family":"Sugimoto","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Nara Medical University Kashihara Nara Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Habata","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Nara Medical University Kashihara Nara Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshinori","family":"Takakura","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Nara Medical University Kashihara Nara 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