Intercondylar eminence avulsion fracture in children: long-term follow-up of 14 cases at the end of skeletal growth

Tudisco, Cosimo; Giovarruscio, Roberto; Febo, Alessandro; Savarese, Eugenio; Bisicchia, Salvatore

doi:10.1097/bpb.0b013e32833a5f4d

Cited by 56 publications

(90 citation statements)

References 31 publications

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“…One study demonstrated that tibial eminence fractures were more likely to occur rather than ACL tears when loading rates were slower [5,6]. This study also noted some plastic deformation with permanent elongation of ACL fibers prior to the fracture occurring, which may cause the clinical laxity that can accompany these injuries despite anatomic fracture reduction [11][12][13].…”

Section: Mechanism Of Injury/symptomsmentioning

confidence: 81%

Pediatric ACL injuries: evaluation and management

Mall¹,

Paletta

2013

Curr Rev Musculoskelet Med

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The anterior cruciate ligament (ACL) is a stabilizing structure to both anterior translation of the tibia with respect to the femur as well as rotation of the knee joint. Children and adolescents are susceptible to these injuries, and there are some who believe the incidence of ACL injuries in this population is increasing due to year round single sport participation. Pediatric ACL injuries are typically seen in several forms: tibial avulsion fractures, partial ACL tears, and full thickness ligament tears. There were and still are some who feel that ACL injuries should be treated non-operatively in the pediatric and adolescent population; however, recent literature refutes this notion. Several factors must be considered during pediatric and adolescent ACL reconstruction, each of which will be examined in this manuscript, including: status of the physis, reconstruction technique, and graft source.

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Section: Mechanism Of Injury/symptomsmentioning

confidence: 81%

Pediatric ACL injuries: evaluation and management

Mall¹,

Paletta

2013

Curr Rev Musculoskelet Med

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“…The remaining 13 studies assessed the outcomes of operatively treated fractures only (►Table 1). 2,3,9,10,13,18,19,[21][22][23][24][25][26][27][28][29] A total of 308 knees were included in the analysis, 20 nonoperatively treated and 288 operatively treated. The minimum follow-up ranged from 2 to 12 years (pooled mean follow-up 35 months).…”

Section: Operative Versus Nonoperative Treatmentmentioning

confidence: 99%

Treatment of Tibial Eminence Fractures: A Systematic Review

et al. 2014

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Fractures of the tibial eminence are rare, accounting for less than 1% of the injuries involving the anterior cruciate ligament (ACL). Most agree that nondisplaced fractures can be managed nonoperatively, but debate exists over the ideal treatment of displaced fractures. This systematic review evaluates the outcome of nonoperatively and operatively managed displaced tibial eminence fractures. The PubMed, Embase, and Cochrane databases were queried. Inclusion criteria included reported outcomes of displaced tibial eminence fractures, minimum 2-year follow-up, and English language. Outcomes reported were pooled and included the following: clinical instability (Lachman/anterior drawer, pivot shift, and KT 1000), patient-reported pain and/or instability, return to sport, Lysholm, Tegner, and the need for ACL reconstruction. Comparison was made in the outcomes of nonoperatively and operatively treated fractures and between suture and screw fixation techniques. Overall 16 studies met the inclusion criteria. The pooled mean age was 23 years and mean follow-up was 35 months. Clinical instability was seen in 70% of nonoperatively treated patients and 14% of operatively treated patients (p < 0.0001). Patient-reported instability was higher in nonoperatively treated patients (54 vs. 1.2%, p < 0.0001), as was the rate of ACL reconstruction (10 vs. 1.0%, p = 0.036). In comparing suture fixation to screw fixation, patient-reported instability and the rate of ACL reconstruction were equivalent. Patients treated with screw fixation had a higher incidence of clinically measured instability (Lachman and KT arthrometer) and an increased rate of hardware removal (3.9 vs. 64.9%, p < 0.05). Surgically managed patients report less instability, are higher functioning, and require fewer ACL reconstructions when compared with nonoperatively treated patients. Suture fixation was associated with improvements in clinical measures of stability and decreased need for hardware removal; however, patient perception of stability and need for ACL reconstruction was no different between the two treatment methods.

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“…Also, it has been noted with these fractures there is variable degree of plastic deformation with permanent elongation of ACL fibers which may cause residual clinical laxity despite anatomic reduction and healing of fracture [10-12]…”

Section: Biomechanics Of Pediatric Acl Injurymentioning

confidence: 99%

Pediatric ACL Injuries: A Review of Current Concepts

Trivedi

Mishra

Verma

2017

TOORTHJ

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Background: The number of anterior cruciate ligament (ACL) injuries reported in skeletally immature athletes has increased over the past 2 decades. The reasons for this increased rate include the growing number of children and adolescents participating in competitive sports vigorous sports training at an earlier age and greater rate of diagnosis because of increased awareness and greater use of advanced medical imaging. There is a growing need for a consensus and evidence based approach for management of these injuries to frame a dedicated age specific treatment strategy.Methods: This article does a systematic evidence based literature review of management of Pediatric ACL injuries seen in several forms: tibial eminence avulsion fractures partial ACL tears and full thickness ligament tears and its outcome analysis.Results: The mechanism of Safe and effective surgical techniques for children and adolescents with ACL injuries continues to evolve. The numerous age matched techniques are extensively discussed. Neuromuscular training can reduce the risk of ACL injury in adolescent girls.Conclusion: This review outlines the current state of knowledge on diagnosis treatment and prevention of ACL injuries in children and adolescents and helps in guiding the treatment through a dedicated algorithm.

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Intercondylar eminence avulsion fracture in children: long-term follow-up of 14 cases at the end of skeletal growth

Cited by 56 publications

References 31 publications

Pediatric ACL injuries: evaluation and management

Pediatric ACL injuries: evaluation and management

Treatment of Tibial Eminence Fractures: A Systematic Review

Pediatric ACL Injuries: A Review of Current Concepts

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