The physical exam shows focal tenderness at the site of the injury, often with significant ecchymosis and swelling. The patient will be unable to bear weight on the leg or extend the knee because of pain and disruption of the quadriceps mechanism. Management is dependent on the fracture type. For nondisplaced type I fractures, I would immobilize the knee using an immobilizer or a cast for 10 days to 2 weeks, for comfort and to allow healing. The patient should avoid jumping activities for 4 additional weeks.
More complex injuries require open reduction and fixation.
The knee is immobilized for 3 weeks after surgery, followed by progressive rehabilitation. It is usually 2 to 3 months before the patient returns to full athletic activity after an open reduction. Patients who have had tibial tubercle avulsion fractures usually do well. There's no real danger of physeal arrest since skeletal growth is, in almost all cases, complete. Physeal fractures about the knee.