Objectives To study the early effect of treating teenagers with tibial insertion avulsion fracture of anterior cruciate ligament using the single-tibal tunnel,double Endobutton miniature steel plate combined with twin high-strength Ultrabraid Suture suspension fixation under an anthroscopy.Methods Retrospective analysis was conducted on 21 teenagers with tibial insertion avulsion fracture of anterior cruciate ligament treated between May 2012 and June 2015.They were treated using the single-tibal tunnel,double Endonbutton plate combined with twin Ultrabraid Suture suspension system fixation.The X-ray was taken postoperatively at 1 week,1 month,3 months and every 6 months.Anterior drawer and Lachman tests were used to evaluate the postoperative stability of knee joints,while the Lysholm score was recorded to assess the postoperative recovery.Results The average total intraoperative blood loss,operation duration and follow-up time were(53.95 ± 7.10) ml (ranging from 43 to 68 ml),(38.76 ± 7.71)min(ranging between 27 and 55 min),and(21.86 ± 2.78)months,ranging from 18 to 25 months.All fractures were healed without malunion or nonunion as could be seen in the X-ray taken 3 months after the operation.Moreover,none of the patients suffered from complications such as soft tissue infections or extension lag of the knee joints caused by the femoral intercondylar notch impingement syndrome.The Lysholm score of the last follow-up(97.14 ± 1.35)was significantly higher than that before surgery (40.24 ± 5.81).Conclusion The early efficacy of the single-tibal tunnel,double Endonbutton plate combined with twin Ultrabraid Suture suspension system fixation for teenagers with tibial insertion avulsion fracture of anterior cruciate ligament under arthroscopy is satisfactory.