Trends in the Evaluation and Treatment of Tibial Spine Fractures: Perspectives from SAOTI and SEOP Members
Abstract
Background: Tibial spine fractures are rare injuries in the pediatric population, leading to ongoing debate regarding the most appropriate diagnostic algorithms and treatment strategies. This study analyzed the practices and preferences of pediatric orthopedic surgeons affiliated with the Argentine Society of Pediatric Orthopedics and Traumatology (SAOTI) and the Spanish Society of Pediatric Orthopedics (SEOP) in managing these fractures. Materials and Methods: A cross-sectional online survey consisting of 21 questions was distributed to SAOTI and SEOP members in April 2024. Data were collected on demographics, years of experience, case volume, evaluation methods, decision-making processes, and fixation techniques. Results: A total of 112 completed responses were obtained (response rate: 28%). Preoperative evaluation was primarily based on radiographs and advanced imaging (99.1% of respondents). The majority of surgeons (58.9%) preferred an arthroscopic approach, with 48.2% using a combination of fixation methods. Surgeons with more than 10 years of experience were more likely to favor surgical treatment for type II fractures. Although nearly 80% of respondents recommended formal postoperative rehabilitation, fewer than one-third routinely used functional testing to determine return-to-sport readiness. Conclusions: The survey revealed diverse practices and preferences in the evaluation and treatment of tibial spine fractures. These findings highlight the need for further research and standardization to optimize the management of these uncommon injuries.Downloads
References
Skak SV, Jensen TT, Poulsen TD, Stürup J. Epidemiology of knee injuries in children. Acta Orthop Scand
;58(1):78-81. https://doi.org/10.3109/17453678709146348
Scrimshire A, Gawad M, Davies R, George H. Management and outcomes of isolated paediatric tibial spine
fractures. Injury 2018;49(2):437-42. https://doi.org/10.1016/j.injury.2017.11.013
Meyers M, McKeever F. Fracture of the intercondylar eminence of the tibia. J Bone Joint Surg Am 1959;41(2):209-20. PMID: 13630956
Chandler JT, Miller TK. Tibial eminence fracture with meniscal entrapment. Arthroscopy 1995;11(4):499-502.
https://doi.org/10.1016/0749-8063(95)90208-2
Mangeaud A, Elías Panigo DH. 2018 R-Medic. Un programa de análisis estadísticos sencillo e intuitivo. Revista
Methodo 2018;3(1):18-22. https://doi.org/10.22529/me.2018.3(1)05
Mayo MH, Mitchell JJ, Axibal DP, Chahla J, Palmer C, Vidal AF, et al. Anterior cruciate ligament injury at the time of anterior tibial spine fracture in young patients: An observational cohort study. J Pediatr Orthop 2019;39(9):e668-e673. https://doi.org/10.1097/BPO.0000000000001011
Severyns M, Odri GA, Vendeuvre T, Marchand JB, Germaneau A, Dramé M. Meniscal injuries in skeletally
immature children with tibial eminence fractures. Systematic review of literature. Int Orthop 2023;47(10):2439-48. https://doi.org/10.1007/s00264-023-05787-w
Rhodes JT, Cannamela PC, Cruz AI, Mayo M, Styhl AC, Richmond CG, et al. Incidence of meniscal entrapment
and associated knee injuries in tibial spine avulsions. J Pediatr Orthop 2018;38(2):e38-e42. https://doi.org/10.1097/BPO.0000000000001110
Tibial Spine Research Interest Group; Orellana KJ, Houlihan NV, Carter MV, Baghdadi S, Baldwin K, Stevens AC,
et al. Tibial spine fractures in the child and adolescent athlete: A systematic review and meta-análisis. Am J Sports Med 2024;52(5):1357-66. https://doi.org/10.1177/03635465231175674
Callanan M, Allen J, Flutie B, Tepolt F, Miller PE, Kramer D, et al. Suture versus screw fixation of tibial spine
fractures in children and adolescents: A comparative study. Orthop J Sports Med 2019;7(11):2325967119881961.
https://doi.org/10.1177/2325967119881961
Chang CJ, Huang TC, Hoshino Y, Wang CH, Kuan FC, Su WR, et al. Functional outcomes and subsequent surgical procedures after arthroscopic suture versus screw fixation for ACL tibial avulsion fractures: A systematic review and meta-análisis. Orthop J Sports Med 2022;10(4):23259671221085945. https://doi.org/10.1177/23259671221085945
Patel NM, Park MJ, Sampson NR, Ganley TJ. Tibial eminence fractures in children: earlier posttreatment
mobilization results in improved outcomes. J Pediatr Orthop 2012;32(2):139-44. https.//doi.org/10.1097/BPO.0b013e318242310a
Bram JT, Aoyama JT, Mistovich RJ, Ellis HB Jr, Schmale GA, Yen YM, et al. Four risk factors for arthrofibrosis
in tibial spine fractures: A National 10-Site Multicenter Study. Am J Sports Med 2020;48(12):2986-93.
https://doi.org/10.1177/0363546520951192
Tibial Spine Research Group; Prasad N, Aoyama JT, Ganley TJ, Ellis HB Jr, Mistovich RJ, Yen YM, et al. A comparison of nonoperative and operative treatment of type 2 tibial spine fractures. Orthop J Sports Med
;9(1):2325967120975410. https://doi.org/10.1177/2325967120975410
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