{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T22:39:26Z","timestamp":1773527966114,"version":"3.50.1"},"reference-count":40,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Orthop Unfall"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Background Tibial tubercle avulsion fractures are rare, they represent less than 1% of all physeal fractures. Compared to monolateral tibial tubercle avulsion fractures, bilateral occurrence is even rarer. The purpose of this study is to report about the so far largest group of bilateral avulsion fractures and to compare them to unilateral fractures as well as to current literature.<\/jats:p><jats:p>Method All patients who suffered from bilateral tibial tubercle fractures between January 2009 and March 2019 were included. All medical records and radiographs were reviewed and a clinical follow-up was performed. The examined criteria were age, gender, mechanism of injury, classification, risk factors, complications, management and outcomes. Clinical outcome was measured using the well established Tegner activity scale and Lysholm-Gillquist score. The same criteria were analyzed in a literature review of bilateral tibial tubercle fractures to compare our results to available literature.<\/jats:p><jats:p>Results We found four children with bilateral tibial tubercle avulsion fractures. All patients were male with a mean age of 14.5\u2009\u00b1\u20090.7 years (13\u200a\u2013\u200a15). Mean follow-up examination was 13.6\u2009\u00b1\u20096.5 months (8\u200a\u2013\u200a29) after surgery. The avulsions occurred during jumping activities in all cases. All children could no longer stand or move because of sudden pain in the knee. We found type IV fractures in three cases, type III fractures in four cases and one type V fracture according to the Ogden classification. All children were treated by open or closed reduction and stabilization with screws or K-wires. Follow-up showed complete fracture healing without complications in all patients. There were no changes in Tegner activity scale and Lysholm-Gillquist Score and knee function comparable to prior to the accident was achieved in all cases.<\/jats:p><jats:p>Conclusion Good clinical results without restrictions regarding function of the knee joint can be achieved by direct operative treatment of bilateral tibial avulsion fractures. A reduction in sporting activity has not to be expected. There were no differences between bilateral or unilateral tibial tubercle avulsion fractures.<\/jats:p>","DOI":"10.1055\/a-0979-2384","type":"journal-article","created":{"date-parts":[[2019,9,19]],"date-time":"2019-09-19T22:59:02Z","timestamp":1568933942000},"page":"466-474","source":"Crossref","is-referenced-by-count":9,"title":["Bilateral Tibial Tubercle Avulsion Fractures in Children \u2013 Clinical Results of a Rare Fracture"],"prefix":"10.1055","volume":"158","author":[{"given":"Francisco","family":"Fernandez Fernandez","sequence":"additional","affiliation":[{"name":"Orthop\u00e4dische Klinik, Olgahospital Stuttgart"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oliver","family":"Eberhardt","sequence":"additional","affiliation":[{"name":"Orthop\u00e4dische Klinik, Olgahospital Stuttgart"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steffen","family":"Schr\u00f6ter","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Unfall- und Wiederherstellungschirurgie, Berufsgenossenschaftliche Unfallklinik T\u00fcbingen"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Wirth","sequence":"additional","affiliation":[{"name":"Orthop\u00e4dische Klinik, Olgahospital Stuttgart"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Ihle","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Unfall- und Wiederherstellungschirurgie, Berufsgenossenschaftliche Unfallklinik T\u00fcbingen"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2019,9,19]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1007\/s11832-008-0131-z","article-title":"Tibial tuberosity fractures in adolescents","volume":"2","author":"S Frey","year":"2008","journal-title":"J Child Orthop"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1016\/j.knee.2006.04.008","article-title":"Simultaneous bilateral avulsion fractures of the tibial tuberosity in adolescence: a case report and review of over 50 years of literature","volume":"13","author":"S W Hamilton","year":"2006","journal-title":"Knee"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"44","DOI":"10.3109\/17453675408988551","article-title":"On symmetrical bilateral fracture of the tuberositas tibiae and eminentia intercondyloidea","volume":"24","author":"P Borch-Madsen","year":"1954","journal-title":"Acta Orthop Scand"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1097\/01241398-198603000-00013","article-title":"Tibial tubercle avulsions","volume":"6","author":"M J Bolesta","year":"1986","journal-title":"J Pediatr Orthop"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"205","DOI":"10.2106\/00004623-198062020-00006","article-title":"Fractures of the tibial tuberosity in adolescents","volume":"62","author":"J A Ogden","year":"1980","journal-title":"J Bone Joint Surg Am"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1302\/0301-620X.72B2.2312561","article-title":"Fracture of the tibial tubercle in the adolescent","volume":"72","author":"S P Chow","year":"1990","journal-title":"J Bone Joint Surg Br"},{"issue":"177","key":"ref7","first-page":"188","article-title":"Ligament injuries associated with physeal fractures about the knee","author":"K C Bertin","year":"1983","journal-title":"Clin Orthop Relat Res"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1007\/s12178-016-9370-7","article-title":"Physeal fractures about the knee","volume":"9","author":"R M Little","year":"2016","journal-title":"Curr Rev Musculoskelet Med"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1097\/BPO.0b013e318271bb05","article-title":"Tibial tubercle fractures: complications, classification, and the need for intra-articular assessment","volume":"32","author":"N K Pandya","year":"2012","journal-title":"J Pediatr Orthop"},{"issue":"105","key":"ref10","first-page":"4","article-title":"The classic: \u201cFractures and Joint Injuries\u201d by Sir Reginald Watson-Jones, taken from \u201cFractures and Joint Injuries,\u201d by R. 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