Objective To explore the protective treatment strategy and clinical effect of avulsion fracture of tibial insertion of anterior cruciate ligament (ACL) in adolescents. Methods From August 2014 to March 2018, ACL was ligated with two double strand ultrabraid thread clasps in 18 cases of avulsion fracture of ACL at the insertion point of ACL, and tibial tunnel was formed by drilling 2.0mm Kirschner wire into the inner and outer front of the bone groove edge with the help of the ACL positioner. The plane was above the epiphyseal plate of tibial platform, and the ultrabraid thread was led out through each 2.0mm diameter bone tunnel and then along the bone surface. PUSHLOCK screw was applied to the medial tibial tubercle and below the epiphyseal plate of tibia to tighten and fixed the thread. The patients were followed up 1m, 3 m, 6 m, 12 m and 24 m after operation, including anterior drawer test, KT1000, Lysholm and IKDC score and imaging examination. Results The follow-up time was 6-24 m, with an average of 13.7 m. At the last follow-up, all the case achieved bony healing in imaging. The average Lysholm score was (95.4±1.6), the anterior drawer test (-),the average KT-1000 forward movement difference was(1.2±0.8)mm, and aLL the IKDC score were (Class A) in 18 patients. Conclusion The proximal tibial epiphysis is not closed in adolescents. ACL avulsion fracture is fixed with two ultrabraid thread clasps. The tibial tunnel technique which avoids damage to epiphysis plate and PUSHLOCK suture anchor compressive internal fixation technique is safe and reliable. It does not damage to epiphysis. It can exercise early function and recover well after operation.