Abstract:[Objectives] To introduce the surgical technique and preliminary clinical consequence of modified anti-tension plate in the treatment of epiphyseal fractures of the tibial tubercle in adolescents. [Methods] The patient was placed in a supine position with the affected limb abducted to a neutral position, and the knee joint flexed at 25°. A 5 cm incision was made in front of the tibial tubercle, exposing the patellar tendon and the proximal epiphyseal fracture, As hematoma at the fracture ends was debrided and irrigated, the fracture was reduced with a towel clamp, and temporally fixed with 3 Kirschner wires 1.2 mm in diameter. After intraoperative fluoroscopy confirmed good fracture reduction, the patellar tendon was longitudinally split, a modified anti-tension plate was placed across the epiphyseal plate, and fixed with a compression screw, followed by 2 locking screws. If the large bone fragments involving the articular surface, another two 3.5 mm cannulated screws would be used for fixation. At the end of the procedure, an attention was given to suture the longitudinally split patellar tendon. [Results] All patients had the operation performed successfully, and were followed up time for 9 to 18 months, with an average of (15.0±1.4) months. The patients had fracture healed from 2 to 3.1 months, with an average of (2.2±0.2) months, regained normal level of activity 3 to 4 months after surgery, had implants removed 6 months postoperatively. According to Mosier's criteria, the clinical outcome was marked as excellent in 17 patients and good in 1 patient. [Conclusion] The modified tension plate to fix tibial tubercular epiphyseal fracture does obtain satisfactory clinical consequence with quick restoration of the knee function in adolescents.