title: Bilateral Proximal Tibial Sleeve Fractures in a Child: A Case Report.
abstract: BACKGROUND
  A sleeve fracture classically describes an avulsion of cartilage or periosteum with or without osseous fragments and usually occurs at the inferior margin of the patella. Tibial tubercle sleeve fractures in the skeletally immature are extremely rare.
  
  
  METHODS
  In this report the authors describe a 12-year-old boy with no systemic disease and no steroid use who sustained bilateral proximal tibial sleeve fractures whilst playing football. Both ruptures were associated with rupture of the medial patellofemoral ligament and tear of the medial retinaculum. Treatment was performed with primary end-to-end repair, reinforcement with bone anchors and cerclage wires with an excellent outcome.
  
  
  CONCLUSIONS
  We feel this rare, currently unclassified variant of a tibial tubercle avulsion fracture should be recognised and consideration taken to adding it to existing classification systems.
authors.affiliation: Department of Trauma and Orthopaedics, Queen's Hospital Romford, Rom Valley Way, Romford, Essex RM7 0AG, UK.
authors.forename: Daniel
authors.initials: D
authors.lastname: Williams
authors.affiliation: Department of Trauma and Orthopaedics, Queen's Hospital Romford, Rom Valley Way, Romford, Essex RM7 0AG, UK.
authors.forename: Steven
authors.initials: S
authors.lastname: Kahane
authors.affiliation: Department of Trauma and Orthopaedics, Queen's Hospital Romford, Rom Valley Way, Romford, Essex RM7 0AG, UK.
authors.forename: Daud
authors.initials: D
authors.lastname: Chou
authors.affiliation: Department of Trauma and Orthopaedics, Queen's Hospital Romford, Rom Valley Way, Romford, Essex RM7 0AG, UK.
authors.forename: Krishna
authors.initials: K
authors.lastname: Vemulapalli
keywords: Adolescent; Cartilage Fracture; Patella Tendon