Management and outcomes of isolated paediatric tibial spine fractures

Scrimshire, Ashley B; Gawad, Mohammed Abdel; Davies, RussellM.; George, Harvey

doi:10.1016/j.injury.2017.11.013

Cited by 34 publications

(24 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Finally, only 55% patients accepted to be tested with arthrometers. This is an important drawback in our analysis but is a common issue even in other studies investigating this uncommon injury, where loss to follow-up ranged from 17% to 76% [ 10 , 11 , 12 , 37 ]. However, we believe that no significantly different knee laxity is to be detected between children who were tested and children who were not tested, since we did not find any difference in terms of clinical outcomes.…”

Section: Discussionmentioning

confidence: 98%

Good Subjective Outcomes, Stable Knee and High Return to Sport after Tibial Eminence Avulsion Fracture in Children

et al. 2020

View full text Add to dashboard Cite

Avulsion fracture of the tibial spine (TSA) is uncommon in children, although its incidence is increasing with the earlier practice of competitive sport activities. This study aims to report mid to long term outcomes in children who sustained a TSA, with a special focus on a return to sport activities. Skeletally immature patients with a TSA, treated in two orthopedic hospitals, were evaluated for range of motion and knee laxity using KT1000, KiRA and Rolimeter. The pediatric International Knee Documentation Committee score (Pedi-IKDC) and the Hospital for Special Surgery pediatric Functional Activity Brief Scale (Pedi-FABS) questionnaires were recorded during the latest visit. Forty-two children were included. Twenty-six were treated nonoperatively and 16 underwent surgery. At a mean follow-up of 6.9 ± 3.6 years, 36 patients completed the questionnaires and 23 patients were tested with arthrometers. Among them, 96% had normal knee laxity. The Pedi-IKDC score averaged 96.4 ± 5.7 points, while the mean Pedi-FABS was 22.2 ± 5.9 points, without statistically significant differences between groups. Twenty-eight patients (78%) returned to their previous level of sport activity (eight amateur, 13 competitive, seven elite athletes). Eight patients (22%) quit sport, mostly because of re-injury fear. If properly treated, pediatric TSAs achieve a high rate of successful healing, with complete restoration of knee stability and an early return to sport activities.

show abstract

Section: Discussionmentioning

confidence: 98%

Good Subjective Outcomes, Stable Knee and High Return to Sport after Tibial Eminence Avulsion Fracture in Children

et al. 2020

View full text Add to dashboard Cite

show abstract

“…TEF is a rare knee injury, 33 and no randomized controlled test until now reported the comparison of different fixations. A systematic review of Gans et al 34 identified 26 studies with extractable clinical results, however, most of the included studies were level 4 articles.…”

Section: Discussionmentioning

confidence: 99%

Suture versus screw fixation technique for tibial eminence fracture: A meta-analysis of laboratory studies

Chen

et al. 2020

J Orthop Surg (Hong Kong)

View full text Add to dashboard Cite

Purpose: The aim of this study was to compare the biomechanical properties between the suture fixation technique and the screw fixation technique for tibial eminence fracture (TEF). Methods: The current study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed, Embase, and the Cochrane were searched from inception to January 2019 comparing the suture and the screw fixation technique for TEF. The results of the eligible studies were analyzed in terms of stiffness, ultimate failure load, and displacement after the cyclic testing. Results: Six laboratory studies were included with a total of 114 knees: 57 knees were in the FiberWire suture group and 57 knees were in the single-screw group. The suture group had higher stiffness than the screw group, but there was no statistical difference between these two groups. Ultimate failure load in the suture group was statistically higher than that in the screw group. No statistically significant difference existed in displacement after the cyclic testing between the suture group and the screw group. Conclusion: The FiberWire suture fixation may be biomechanically superior to a single screw fixation in TEF treatment in mature knees regarding ultimate failure load, while no significant difference was found between the two fixations in terms of stiffness and displacement after the cyclic testing.

show abstract

“…Following the direction of the ACL, traction was rst applied to the medial pull suture to correct the lateral displacement, then to the anterior pull suture to apply downward pressure on the fractured bone; (3) during reduction, the anterior meniscus and transverse ligament are retracted using probe hooks to avoid affecting fracture reduction; and (4) under arthroscopic monitoring, the double pulley technique was used to adjust the tension of the high-strength suture.…”

Section: E Cacy Evaluationmentioning

confidence: 99%

“…In adult patients, ACL tibial fractures are currently treated using cannulated screws, suture anchors, steel wires, high-strength sutures, and absorbable screws, with a satisfactory therapeutic e cacy in clinical reports. [2][3][4][5] However, as children are still growing and developing, and their treatment principles differ from those of adults, special techniques in fracture reduction and xation, with the aim of avoiding iatrogenic injuries to the epiphysis during surgery when possible, need to be developed. The suture binding technology is widely used for ACL tibial avulsion fracture at present.…”

Section: Introductionmentioning

confidence: 99%

Treatment of Anterior Cruciate Ligament Tibial Avulsion Fracture in Children with Suture Anchor Fixation Outside The Tunnel: A Retrospective study

Chen

Xiao

Wang

2020

Preprint

View full text Add to dashboard Cite

Background: Anterior cruciate ligament (ACL) tibial avulsion fractures are a special ACL injury type, classified as intra-articular fractures. Presently, the main treatment method is arthroscopic surgery, and various fixation methods are available, including use of steel wires, high-strength sutures, cannulated screws, anchors, Kirschner wires, etc. Joint fixation using wire binding could cut through the bone tunnel. We aimed to evaluate the clinical efficacy of a novel method involving suture anchor fixation outside the tunnel to treat anterior cruciate ligament (ACL) tibial avulsion fractures in children.Methods: This retrospective study analyzed the data of 42 pediatric patients (26 boys and 16 girls; age: 7–13 years) with ACL tibial avulsion fractures. Based on the Meyers–McKeever–Zaricznyj classification of fractures, 22, 14, and 6 patients had types II, III, and IV fractures, respectively. All patients underwent arthroscopic surgery for ACL tibial avulsion fracture; during surgery, double tibial tunnels were established, and high-strength sutures were passed through the tunnels and fixed externally with an anchor. The clinical outcome was evaluated by assessing the pre- and post-operative knee joint range of motion (ROM) and by using the Lysholm knee function score and International Knee Documentation Committee (IKDC) score. Post-operative computed tomography and magnetic resonance images were reviewed to determine the status of fracture displacement, healing, and epiphyseal damage.Results: All 42 patients were followed up for 20–36 months (average of 27.8 months). Knee ROM increased from 48.2°±21.7° pre-operatively to 131.6°±8.7° at the final follow-up (t=23.119, P=0.000). The Lysholm knee function score increased from 37.6±5.2 points pre-operatively to 90.1±6.3 points post-operatively, representing a significant improvement (t=41.651, P=0.000). The IKDC score improved from 43.3±7.5 points pre-operatively to 91.3±5.7 points post-operatively (t=45.521, P=0.000). The imaging findings indicated that the fractures healed with displacement and there was no significant epiphyseal damage.Conclusions: Suture anchor fixation outside the tunnel to treat ACL tibial avulsion fracture in children reduces the cutting action of the sutures on the tunnel, minimizes epiphyseal damage, involves a simple procedure, offers firm fixation, and effectively improves knee function. This approach can enable early functional rehabilitation and achieve satisfactory clinical efficacy.

show abstract

Management and outcomes of isolated paediatric tibial spine fractures

Cited by 34 publications

References 23 publications

Good Subjective Outcomes, Stable Knee and High Return to Sport after Tibial Eminence Avulsion Fracture in Children

Good Subjective Outcomes, Stable Knee and High Return to Sport after Tibial Eminence Avulsion Fracture in Children

Suture versus screw fixation technique for tibial eminence fracture: A meta-analysis of laboratory studies

Treatment of Anterior Cruciate Ligament Tibial Avulsion Fracture in Children with Suture Anchor Fixation Outside The Tunnel: A Retrospective study

Contact Info

Product

Resources

About