Mid-term outcomes of arthroscopic suture fixation technique in tibial spine fractures in the pediatric population

Ulus Travma Acil Cerrahi Derg. 2021 Sep;27(5):571-576. doi: 10.14744/tjtes.2020.25905.

Abstract

Background: Tibial spine fractures are avulsion injuries that are a similar mechanism to anterior cruciate ligament rupture. Although its incidence is not very common, it can cause possible complications and permanent sequelae in the knee joint if not treated correctly. The aim of this study was to evaluate the mid-term results of the arthroscopic suture technique for tibial spine fractures in a pediatric population.

Methods: Analyzed retrospectively were 28 patients who underwent the arthroscopic suture fixation technique at our clinic, due to type 2 (with >5 mm displacement), 3 and 4 tibial spine fractures, between January 2013 and December 2017. The demographic features, injury mechanism, fracture classification, mean follow-up time, radiographic healing time, return to activity time, instability examination, joint range of motion (ROM), and knee injury and Osteoarthritis Outcome Score (KOOS) parameters of the patients were evaluated both clinically and functionally.

Results: The mean age of the patients was 14.2. In addition, 17 patients were male (61%) and 20 had a healthy body mass index (71%). According to the modified Meyer and McKeever classification, type 2 tibial spine fracture was most common. The mean follow-up period was 4.64 years and the mean radiological healing time was calculated as 2.17 months. Of these patients, 27 were fully functional in terms of ROM (96%). Secondary surgery was performed on 1 patient due to arthrofibrosis and severely limited ROM. The mean 6-month KOOS was 82.3, while the 12-month KOOS was 91.4 and the 24-month KOOS was 95.7. A significant difference was observed between these scores (p=0.024).

Conclusion: The outcomes of the arthroscopic suture technique for the treatment of tibial spine fractures in a pediatric population were both clinically and functionally satisfactory. Anatomic reduction and early rehabilitation increased the success rate in the treatment of these fractures. Longer follow-up will provide more information.