A “Suture Staple” Knotless Anchor Technique for Fixation of Tibial Tubercle Avulsion Fractures in Pediatric Patients

Abstract

Tibial tubercle fractures are rare injuries most commonly seen in the pediatric population; more specifically the adolescent male population towards the end of peak longitudinal growth. Typically, tibial tubercle fractures are fixed with cannulated screws. However, there is a subsection of patients with tibial tubercle avulsion fractures in which the fracture fragment is small and attempts at screw fixation may lead to screw cut‐out and fragment damage. To address this, we describe a technique for small or thin tibial tubercle fractures using a tensionable knotless anchor construct with 2‐4 independent mattress sutures placed in a staple configuration. This method employs the biomechanical strength of knotless fixation while eliminating the potential single point of failure and hardware prominence seen with screws and knotted anchors.