Open Versus Arthroscopic Reduction for Tibial Eminence Fracture Fixation in Children

Watts, Chad D.; Larson, A. Noelle; Milbrandt, Todd A.

doi:10.1097/bpo.0000000000000476

Cited by 55 publications

(68 citation statements)

References 14 publications

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“…As previously mentioned, surgical delay and operative time were significantly longer in the ARIF group, possibly because patients were waiting for a specialist who could perform arthroscopic surgery. 56 Several other studies have noted a higher risk of arthrofibrosis with high-energy injuries and concomitant collateral ligament and meniscus injuries. 54,105,107 In patients with concurrent ligamentous injuries, an early intervention for ligamentous reconstruction (within 1 week of injury) increases the risk of arthrofibrosis when compared with reconstruction after 3 weeks.…”

Section: Arthrofibrosismentioning

confidence: 96%

“…The authors hypothesized that patients waiting for a specialist capable of performing ARIF may be subjected to delayed surgery, as well as prolonged surgery, and thus concluded that ORIF and ARIF are both acceptable methods and should be chosen based upon which can be performed more efficiently. 56 Others theorize that if the patient's knee is at its stiffest at the time of initial presentation, and stiffness is not the result of mechanical obstruction from a displaced fracture fragment, then patients can work on increasing preoperative ROM to achieve better postoperative ROM, similar to the prehabilitation goals with ACL rupture. 57…”

Section: Arthroscopic Versus Open Approachmentioning

confidence: 99%

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Tibial Spine Fractures in Children: Evaluation, Management, and Future Directions

et al. 2018

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Fractures of the tibial spine are estimated to occur in 3 per 100,000 children annually, but account for 2 to 5% of pediatric knee injuries with effusion. Although these fractures were historically associated with bicycle accidents, the surge of organized youth sports in recent decades has brought renewed attention to this injury. While minimally displaced fractures can be treated nonoperatively, several techniques have been described for fixation of displaced or comminuted fractures. Sequelae of this injury can include arthrofibrosis, knee instability, and nonunion. Future collaborative endeavors will aim to further identify risk factors for these complications to optimize the treatment of tibial spine fractures in children.

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Section: Arthrofibrosismentioning

confidence: 96%

Section: Arthroscopic Versus Open Approachmentioning

confidence: 99%

Tibial Spine Fractures in Children: Evaluation, Management, and Future Directions

et al. 2018

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“…~n reduction and fixation remains an acceP.table option, and surgeons should approach tibial eminence fractures witli whichever mode they can accomplish the task with higher efficiency . 9 Screw removal is not recommended in case of full recovery.…”

Section: Tibial Eminence Fracturementioning

confidence: 99%

Arthroscopic Treatment of Pediatric Fractures

Accadbled

N’Dele

2018

Journal of Pediatric Orthopaedics

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Management of pediatric articular fractures has evolved over the years with a growing interest in arthroscopic handling. Several factors account for this recent appeal among which are progress in technology with increased availability of diagnostic methods, rise in athletic activities responsible for these fractures, and pediatric orthopaedic surgeons getting familiar with arthroscopic techniques. In our institution, 9 of 100 arthroscopic procedures are performed as a consequence of an articular fracture. In total, 80% of the fractures concern the knee (56% of tibial eminence fracture, 24% osteochondral fracture). Most of the remaining 20% are located at the ankle joint. Given the thorough articular exploration that arthroscopy provides, any associated cartilaginous or meniscal lesions is identified and addressed in the same procedure as the fracture fixation. Being a less invasive surgery with low complication rate, arthroscopic management of pediatric articular fractures provides very satisfactory results with earlier recovery. Of note, it is technically demanding and requires constant training. The operative time should be monitored and alternative options considered for each surgery. In this regard, arthroscopy has to be viewed as a means not an end.

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“…In direct contrast, data exist in the pediatric literature which suggest an association between increased time to surgery and arthrofibrosis development in children treated for isolated tibial spine fractures. 14 Additionally, performing surgical repair of an avulsed ligament (bony or no) in the first several days after injury generally allows for easier identification of anatomic structures and easier mobilization and reduction of injured structures. Balancing these competing rationales for early and delayed surgery in this population poses a challenge for the treating surgeon.…”

Section: Discussionmentioning

confidence: 99%

“Multiligamentous” Injuries of the Skeletally Immature Knee: A Case Series and Literature Review

Badrinath¹,

Carter

2018

JAAOS Glob Res Rev

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Multiligamentous knee injuries occur rarely in the pediatric population. Few reports are available in the existing literature; furthermore, no longitudinal studies regarding the choice of treatment and long-term outcomes for this unique population have been published. To fill this knowledge gap, the literature on multiligamentous injuries of the knee in the adult population is commonly used as a guideline in clinical decision making for children and adolescents. However, the developing bone and physis are often weaker than the ligamentous structures of the knee—particularly during periods of rapid growth—and may be the first to fail in the event of injury or trauma. Bony avulsion fractures and peri-physeal fractures, rather than mid-substance ligamentous ruptures, may result. Patients with skeletal immaturity may therefore present with different patterns of multiligamentous injury after acute trauma to the knee. This article describes the clinical presentation, our treatment approach, and short-term outcomes for three pediatric patients with multiligamentous injuries of the knee and reviews the current literature relating to these uncommon injuries.

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Open Versus Arthroscopic Reduction for Tibial Eminence Fracture Fixation in Children

Abstract: Level III-therapeutic study.

Cited by 55 publications

References 14 publications

Tibial Spine Fractures in Children: Evaluation, Management, and Future Directions

Tibial Spine Fractures in Children: Evaluation, Management, and Future Directions

Arthroscopic Treatment of Pediatric Fractures

“Multiligamentous” Injuries of the Skeletally Immature Knee: A Case Series and Literature Review

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