Case: In this case report, we discuss a skeletally immature gymnast who presented with an isolated distal femoral adductor tubercle avulsion fracture that went on to develop a painful nonunion. After the failure of extensive nonoperative intervention, she had resolution of her symptoms with bony excision and soft-tissue repair.
Conclusion: It is important for clinicians to be aware of this atypical injury pattern and that surgical intervention may be necessary because conservative treatment may not always resolve symptoms.