The frontal knee x-ray shows a bipartite patella (developmental anomaly, not to be mistaken for a patellar fracture. Affects 8% of populations, bilateral in 50% of cases and seen in the superolateral aspect of patella).

The HBL x-ray shows an avulsion fracture of the tibial tubercle and a high riding patella as a result (patella alta). Tibial tubercle fracture is an uncommon fracture that occurs in adolescent age group due to sudden quadriceps contraction.

The tibial tubercle fracture was managed operatively.

Reference: www.orthobullets.com