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- Title
TIBIAL SPINE AVULSIONS IN THE SKELETALLY IMMATURE.
- Authors
Vermesan, D.; Prejbeanu, R.; Haragus, H.; Vermesan, S.; Damian, G.
- Abstract
In children, displaced avulsions of the tibial spine are equivalent to ruptures of the anterior cruciate ligament. They present to general orthopaedists as well as a wide variety of orthopedic subspecialty surgeons including sports medicine and pediatrics. Restoration of normal knee kinematics is dependent on anatomic reduction and fixation of the avulsed fragment. Given these premises we aimed to evaluate the current treatment of displaced tibial spine fractures in the skeletally immature in our clinic. We performed a retrospective review of displaced avulsions of the tibial spine in skeletally immature patients treated in our clinic over the last years and identified 4 cases: 3 girls and one boy, with a mean age of 12 (11-14). One case was type II and three were type III. All were treated operatively: 2 with arthroscopic/mini-open reduction and internal fixation using wire, one with screw and one with 2 K wires. The patients had the final follow-up evaluation at a mean of 20 months after index surgery. All had IKDC scores for excellent and good outcomes. Three out of four cases had increased manual antero-posterior tibial translation without subjective feeling of instability. All patients had regained full range of motion by the time of final examination even though incomplete recovery was noted for the three cases which returned for implant removal before the second operation. In our patients, surgical treatment has offered good final outcomes. Arthroscopic evaluation has proved extremely useful in articular exploration for associated lesions as well as reduction and internal fixation. However, extended approaches were needed for adequate stabilization, although this was at most at the mini-open level. Wire has offered good fixation but the screw offered less postoperative symptoms and did not require removal. All three methods were comfortably kept within the epiphyses and did not create concern regarding the open growth cartilage.
- Subjects
TIBIA injuries; AVULSION fractures; SKELETAL muscle; CHILDREN'S injuries; SPINAL injuries; ANTERIOR cruciate ligament injuries; ORTHOPEDIC surgery
- Publication
Jurnalul Pediatrului, 2012, Vol 15, Issue 59/60, p59
- ISSN
2360-4557
- Publication type
Article