Clinical and radiological results of arthroscopically treated tibial spine fractures in childhood

Perugia, D; Basiglini, Luca; Vadalà, Antonio; Ferretti, Andrea

doi:10.1007/s00264-008-0697-6

Cited by 52 publications

(75 citation statements)

References 22 publications

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“…One study demonstrated that tibial eminence fractures were more likely to occur rather than ACL tears when loading rates were slower [5,6]. This study also noted some plastic deformation with permanent elongation of ACL fibers prior to the fracture occurring, which may cause the clinical laxity that can accompany these injuries despite anatomic fracture reduction [11][12][13].…”

Section: Mechanism Of Injury/symptomsmentioning

confidence: 82%

Pediatric ACL injuries: evaluation and management

Mall¹,

Paletta

2013

Curr Rev Musculoskelet Med

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The anterior cruciate ligament (ACL) is a stabilizing structure to both anterior translation of the tibia with respect to the femur as well as rotation of the knee joint. Children and adolescents are susceptible to these injuries, and there are some who believe the incidence of ACL injuries in this population is increasing due to year round single sport participation. Pediatric ACL injuries are typically seen in several forms: tibial avulsion fractures, partial ACL tears, and full thickness ligament tears. There were and still are some who feel that ACL injuries should be treated non-operatively in the pediatric and adolescent population; however, recent literature refutes this notion. Several factors must be considered during pediatric and adolescent ACL reconstruction, each of which will be examined in this manuscript, including: status of the physis, reconstruction technique, and graft source.

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Section: Mechanism Of Injury/symptomsmentioning

confidence: 82%

Pediatric ACL injuries: evaluation and management

Mall¹,

Paletta

2013

Curr Rev Musculoskelet Med

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“…Also, it has been noted with these fractures there is variable degree of plastic deformation with permanent elongation of ACL fibers which may cause residual clinical laxity despite anatomic reduction and healing of fracture [10-12]…”

Section: Biomechanics Of Pediatric Acl Injurymentioning

confidence: 99%

Pediatric ACL Injuries: A Review of Current Concepts

Trivedi

Mishra

Verma

2017

TOORTHJ

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Background: The number of anterior cruciate ligament (ACL) injuries reported in skeletally immature athletes has increased over the past 2 decades. The reasons for this increased rate include the growing number of children and adolescents participating in competitive sports vigorous sports training at an earlier age and greater rate of diagnosis because of increased awareness and greater use of advanced medical imaging. There is a growing need for a consensus and evidence based approach for management of these injuries to frame a dedicated age specific treatment strategy.Methods: This article does a systematic evidence based literature review of management of Pediatric ACL injuries seen in several forms: tibial eminence avulsion fractures partial ACL tears and full thickness ligament tears and its outcome analysis.Results: The mechanism of Safe and effective surgical techniques for children and adolescents with ACL injuries continues to evolve. The numerous age matched techniques are extensively discussed. Neuromuscular training can reduce the risk of ACL injury in adolescent girls.Conclusion: This review outlines the current state of knowledge on diagnosis treatment and prevention of ACL injuries in children and adolescents and helps in guiding the treatment through a dedicated algorithm.

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“…34,39,43,44 However, recently many authors report minimal incidence of arthrofibrosis after arthroscopic rigid fixation and early mobilization within 2 to 4 weeks, indicating that early mobilization can reduce the rate of arthrofibrosis and improve the outcome. [15][16][17][18]41 In our study, only two patients (7.7%) had postoperative knee stiffness who recovered completely after arthroscopic adhesiolysis. One patient, who was 12-year-old, had 10-degree extension deficit.…”

Section: Complicationsmentioning

confidence: 97%

Arthroscopic Suture Pull-Out Fixation of Displaced Tibial Spine Avulsion Fracture

et al. 2016

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The aim of this study is to assess the clinical and radiological outcomes of arthroscopic reduction and fixation of tibial spine avulsion in patients with either open physis or closed physis, using high strength nonabsorbable sutures utilizing intravenous cannula needle as suture passer and retriever. Twenty-six patients of mean age 24.5 years were included in the study with a mean follow-up period of 31 months. Twelve patients had McKeever type III avulsion fracture and 14 had type IV. A follow-up analysis was performed using fracture union time, range of motion assessment, and Lysholm and IKDC (International Knee Documentation Committee) scores with instrumental (KT-1000 arthrometer) laxity assessment. All avulsion fractures showed union at the end of a 3-month follow-up. Mean (± standard deviation [SD]) postoperative Lysholm and IKDC subjective scores were 97.7 (± 3.62, range, 89-100) and 95.55 (± 4.21, 82.8-100), respectively. All patients were graded IKDC grade A except one with grade B. The Lysholm score of open physis group was better than the closed physis group (99.6 vs. 96.5, < 0.03), whereas IKDC scores of open versus closed physis group (both subjective and objective) and type III and IV McKeever groups did not reveal any statistical difference. KT-1000 assessment revealed mean (± SD) anterior translation of the tibia as 0.85 (±0.9) mm. At the final follow-up, all patients achieved complete range of movement with no symptom of instability. Two patients underwent adhesiolysis for postoperative stiffness in their knee at 4th month postoperatively. Arthroscopic suture pull-out fixation for type III and IV tibial spine avulsion results in excellent clinical and radiological outcomes in patient with open and closed physis without any significant complications. This is a prospective case series with level of evidence IV.

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Clinical and radiological results of arthroscopically treated tibial spine fractures in childhood

Abstract: The objective of this study

Cited by 52 publications

References 22 publications

Pediatric ACL injuries: evaluation and management

Pediatric ACL injuries: evaluation and management

Pediatric ACL Injuries: A Review of Current Concepts

Arthroscopic Suture Pull-Out Fixation of Displaced Tibial Spine Avulsion Fracture

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