• Lei Tan, Yan-Hui Li, Yuying Li, Tong Lin, Dong Zhu, and Da-Hui Sun.
• Department of Orthopedic Trauma Department of Cardiology and Echocardiography Department of Hematology, The First Hospital of Jilin University, Changchun, China.
• Medicine (Baltimore). 2018 Sep 1; 97 (36): e12015e12015.

RationaleTibial tuberosity fractures most often occur in the adolescents. Fracture of tibial tuberosity in adults is extremely rare with only 5 reported cases till date. Tibial plateau fractures combined with tibial tubercle fractures are not common.Patient ConcernsWe report here a type B3 tibial plateau fracture (AO classification) with a concomitant fracture of tibial tuberosity.DiagnosesAnteroposterior and lateral knee view radiographs revealed a complex comminuted fracture of the right tibial plateau (AO Type B3; Schatzker Type IV) with tibial tubercle fracture. Three-dimensional computed tomography (CT) showed that the tibial media plateau was split into 2 pieces in the sagittal plane, along with the isolated tibial tubercle.InterventionsThe open procedure was performed first and a standard posteromedial approach for medial and posteromedial tibial plateau fracture was used with double locking plate fixation. The tibial tuberosity was fixed with a cortical screw.OutcomesThe patient showed full range of motion in right knee after 8 weeks. The patient was allowed full weight bearing at 4 months. Eight months after operation, he was asymptomatic, showed a full range of motion and good strength. He had returned to work with no limitations.LessonsFractures of the partial tibial plateau combined with tibial tubercle are present and should not be ignored. Accurate diagnosis and proper treatment will help achieve favorable outcomes in these patients.

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