Nonoperative treatment of tibial spine fractures in children-38 patients with a minimum follow-up of 1 year.

OBJECTIVES

The aim of this study was to determine if nonoperative treatment of fractures of the tibial spine (intercondylar eminence) in pediatric patients is the treatment of choice for these injuries.

DESIGN/SETTING: Retrospective clinical analysis in a single department.

PATIENTS

All patients younger than 17 years presenting with a fracture of the intercondylar eminence between January 1, 1995 and December 31, 2004 were included in this retrospective study. Patients with ossification of the growth plate (physis) at the time of accident were excluded by protocol.

INTERVENTION

Nonoperative treatment with knee aspiration, reduction, and immobilization in a long leg cast.

MAIN OUTCOME MEASUREMENTS

History-taking and follow-up examinations were performed using the Cincinnati Knee Score and International Knee Documentation Committee Guidelines of 2000. In addition, a magnetic resonance imaging scan of the injured knee was offered to all patients. SPSS 12.0 and Microsoft Excel 2000 were used for data processing and statistical analysis.

RESULTS

Forty-three patients have been included in the study. Twenty-three were female and 20 male. The mean age at trauma was 11.5 years (6-16 years). Only 1 patient required a change of therapy and needed open reduction. Thirty-eight patients were available for follow-up at an interval of 1-7.5 years after trauma (mean 3.5 years). None of the patients reported pain, swelling, disability or giving-way, or was handicapped in their daily life. Of 26 magnetic resonance imaging examinations, we found a missing anterior cruciate ligament in 1 and a partial rupture in another patient.

CONCLUSION

Based on our results, nonoperative management can still be recommended as the primary treatment for tibial spine fractures in children.