Comparative finite element analysis of fixation strategies for sports-related tibial tuberosity avulsion fractures in adolescents: biomechanical evidence for optimized clinical decision-making

Biomechanical analysis of TTAF reveals that screw fixation provides enhanced stability and reduced bone stress compared to K-wire fixation. Furthermore, the stability achieved with dual screws is comparable to that of triple screws, implying that adding more implants offers a limited advantage in fracture fixation stability. Considering the greatest physeal insult, particularly in skeletally immature individuals with retained growth potential, tension band wiring should be used sparingly. Based on these results, screw fixation is recommended as the optimal approach for adolescent TTAF.