PEDIATRIC TIBIAL SPINE FRACTURES – TREATMENT OPTIONS

摘要

Pediatric fractures of the tibial spine are relatively rare and controversy remains around how these injuries are best managed. Consequently most non-specialized paediatric units have limited experience of managing these injuries. Injuries that rupture the ACL of an adult typically avulse the anterior tibial spine in a growing child. The conservative treatment of un-displaced fractures (type I) is unambiguous and simple. However, difficulties may arise in relation to the treatment of type II and III fractures, since an anatomical reduction of the fracture and reconstruction of the articular surface are required to preserve the function and the stability of the knee joint. Several methods have been described for the treatment of avulsion of tibial eminence, including operations performed by using either arthrotomy or arthroscopy. The fixation of the fragments can be performed by utilizing Kirschner wires, cerclage wires, intraosseal sutures, epiphyseal cannulated screws, screws led through the fragment and screws and bone anchors inserted retrogradely.