TY  - JOUR
PY  - 2023//
TI  - Tibial spine fractures in the child and adolescent athlete: a systematic review and meta-analysis
JO  - American journal of sports medicine
A1  - Orellana, Kevin J.
A1  - Houlihan, Nathan V.
A1  - Carter, Michael V.
A1  - Baghdadi, Soroush
A1  - Baldwin, Keith
A1  - Stevens, Alexandra C.
A1  - Cruz, Aristides I. Jr
A1  - Ellis, Henry B. Jr
A1  - Green, Daniel W.
A1  - Kushare, Indranil
A1  - Johnson, Benjamin
A1  - Kerrigan, Alicia
A1  - Kirby, Julia C.
A1  - MacDonald, James P.
A1  - McKay, Scott D.
A1  - Milbrandt, Todd A.
A1  - Justin Mistovich, R.
A1  - Parikh, Shital
A1  - Patel, Neeraj
A1  - Schmale, Gregory
A1  - Traver, Jessica L.
A1  - Yen, Yi-Meng
A1  - Ganley, Theodore J.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: Tibial spine fractures (TSFs) are uncommon injuries that may result in substantial morbidity in children. A variety of open and arthroscopic techniques are used to treat these fractures, but no single standardized operative method has been identified. <br><br>PURPOSE: To systematically review the literature on pediatric TSFs to determine the current treatment approaches, outcomes, and complications. STUDY DESIGN: Meta-analysis; Level of evidence, 4. <br><br>METHODS: A systematic review of the literature was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) guidelines using PubMed, Embase, and Cochrane databases. Studies evaluating treatment and outcomes of patients <18 years old were included. Patient demographic characteristics, fracture characteristics, treatments, and outcomes were abstracted. Descriptive statistics were used to summarize categorical and quantitative variables, and a meta-analytic technique was used to compare observational studies with sufficient data. <br><br>RESULTS: A total of 47 studies were included, totaling 1922 TSFs in patients (66.4% male) with a mean age of 12 years (range, 3-18 years). The operative approach was open reduction and internal fixation in 291 cases and arthroscopic reduction and internal fixation in 1236 cases; screw fixation was used in 411 cases and suture fixation, in 586 cases. A total of 13 nonunions were reported, occurring most frequently in Meyers and McKeever type III fractures (n = 6) and in fractures that were treated nonoperatively (n = 10). Arthrofibrosis rates were reported in 33 studies (n = 1700), and arthrofibrosis was present in 190 patients (11.2%). Range of motion loss occurred significantly more frequently in patients with type III and IV fractures (P <.001), and secondary anterior cruciate ligament (ACL) injury occurred most frequently in patients with type I and II fractures (P =.008). No statistically significant differences were found with regard to rates of nonunion, arthrofibrosis, range of motion loss, laxity, or secondary ACL injury between fixation methods (screw vs suture). <br><br>CONCLUSION: Despite variation in TSF treatment, good overall outcomes have been reported with low complication rates in both open and arthroscopic treatment and with both screw and suture fixation. Arthrofibrosis remains a concern after surgical treatment for TSF, but no significant difference in incidence was found between the analysis groups. Larger studies are necessary to compare outcomes and form a consensus on how to treat and manage patients with TSFs.<p />  <p>Language: en</p>
LA  - en
SN  - 0363-5465
UR  - http://dx.doi.org/10.1177/03635465231175674
ID  - ref1
ER  -