Bifocal Avulsion of the Patellar Tendon from the Distal Patella and Tibial Tuberosity in a Skeletally Immature Patient: A Case Report

Case: A 13-year-old boy suffered a sports injury of the right knee. The clinical examination showed swelling, inability to bear weight, and pain involving the inferior apex of the patella and the anterior tibial tuberosity. Imaging studies showed an avulsion fracture, sleeve-like, from the patella apex and avulsion of the tibial tuberosity. The patient underwent open reduction and internal fixation. At the 24-month follow-up, no pain, limitation, or complication was reported. Conclusions: Bifocal patellar tendon avulsion in a skeletally immature patient is an extremely rare injury, and to our knowledge, only one case is reported.