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Tibial Spine Fractures in the Child and Adolescent Athlete: A Systematic Review and Meta-analysis.
- Source :
-
American Journal of Sports Medicine . Apr2024, Vol. 52 Issue 5, p1357-1366. 10p. - Publication Year :
- 2024
-
Abstract
- 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. 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. 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. 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). 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. [ABSTRACT FROM AUTHOR]
- Subjects :
- *MEDICAL information storage & retrieval systems
*SPORTS medicine
*FRACTURE fixation
*ARTHROSCOPY
*EVALUATION of medical care
*META-analysis
*DESCRIPTIVE statistics
*ATHLETES
*SYSTEMATIC reviews
*MEDLINE
*TIBIA injuries
*MEDICAL databases
*ONLINE information services
*HEALTH outcome assessment
*RANGE of motion of joints
*DISEASE complications
*ADOLESCENCE
*CHILDREN
Subjects
Details
- Language :
- English
- ISSN :
- 03635465
- Volume :
- 52
- Issue :
- 5
- Database :
- Academic Search Index
- Journal :
- American Journal of Sports Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 176404851
- Full Text :
- https://doi.org/10.1177/03635465231175674