Combined Tibial Tubercle Fracture and Patellar Tendon Rupture in Adolescents: A Report of Three Cases Highlighting Fragment Rotation as a Diagnostic Clue

We report three adolescent boys with combined tibial tubercle fracture and patellar tendon rupture. All presented with pain, swelling, and inability to actively extend the knee. Initial radiographs demonstrated tibial tubercle fractures, and complete fragment rotation was present in two cases. All patients underwent tibial tubercle fixation and patellar tendon repair. At final follow-up, all achieved fracture union, full active knee extension, and return to their pre-injury or higher activity level. Complete fragment rotation may represent an early radiographic clue to associated patellar tendon avulsion and may facilitate timely recognition and surgical treatment of this rare combined injury pattern.