Type 4 Tibial Tuberosity Avulsion Fractures: Surgical Treatment Early Outcomes and a Presentation of the Distal Cortical Fixation.

: The most published surgical technique for fixating Type 4 (Salter-Harris II) tibial tubercle avulsion fractures is uni-cortical in nature, and stability is suboptimal. This study presents a technique modification that is consistent with AO principles, by which the screws are aimed distally to purchase the posterior cortex of the distal fragment. This technique is defined as a "Distal Cortical Fixation".