Good Subjective Outcomes, Stable Knee and High Return to Sport after Tibial Eminence Avulsion Fracture in Children

Abstract

Avulsion fracture of the tibial spine (TSA) is uncommon in children, although its incidence is increasing with the earlier practice of competitive sport activities. This study aims to report mid to long term outcomes in children who sustained a TSA, with a special focus on a return to sport activities. Skeletally immature patients with a TSA, treated in two orthopedic hospitals, were evaluated for range of motion and knee laxity using KT1000, KiRA and Rolimeter. The pediatric International Knee Documentation Committee score (Pedi-IKDC) and the Hospital for Special Surgery pediatric Functional Activity Brief Scale (Pedi-FABS) questionnaires were recorded during the latest visit. Forty-two children were included. Twenty-six were treated nonoperatively and 16 underwent surgery. At a mean follow-up of 6.9 ± 3.6 years, 36 patients completed the questionnaires and 23 patients were tested with arthrometers. Among them, 96% had normal knee laxity. The Pedi-IKDC score averaged 96.4 ± 5.7 points, while the mean Pedi-FABS was 22.2 ± 5.9 points, without statistically significant differences between groups. Twenty-eight patients (78%) returned to their previous level of sport activity (eight amateur, 13 competitive, seven elite athletes). Eight patients (22%) quit sport, mostly because of re-injury fear. If properly treated, pediatric TSAs achieve a high rate of successful healing, with complete restoration of knee stability and an early return to sport activities.

Long-term Outcomes of Tibial Spine Avulsion Fractures After Open Reduction With Osteosuturing Versus Arthroscopic Screw Fixation: A Multicenter Comparative Study

“…Patients who underwent reoperation had lower IKDC scores but experienced no further impediments to returning to their previous levels of play in sports. In the literature, pain and fear of reinjury have been the most common patient-reported reasons for failing to return to preinjury-level play, 30 which is consistent with the findings of this research.…”

“…Most patients recover well after a TSA fracture. 7,23,26-28, 30 Stallone et al 30 reported good outcomes after operative and nonoperative care, although their study population was small and the majority of the participants were treated nonoperatively (23 vs 16). Furthermore, 78% of their patients returned to their previous levels of play in sports, and the mean Pedi-IKDC score was 96.4 ± 5.7.…”

Effect of Remote Control Augmented Reality Multimedia Technology for Postoperative Rehabilitation of Knee Joint Injury

“…However, immobilization can cause pathological changes in the body's joint capsule, ligaments, muscles, and other tissues in terms of morphological structure, biochemistry, and biochemical mechanics and ultimately affect the function of joints and limbs [ 13 ]. In order to avoid knee joint dysfunction, a comprehensive treatment based on early functional activities has to be adopted [ 14 ].…”