Reyes Chloe Delos, Wu Wei, Pandya Nirav K
John A. Burns School of Medicine, University of Hawaii, Honolulu, USA.
Department of Orthopedic Surgery, Benioff Children's Hospital, University of California, San Francisco, San Francisco, CA, 94609, USA.
Curr Rev Musculoskelet Med. 2023 Sep;16(9):392-397. doi: 10.1007/s12178-023-09849-9. Epub 2023 Jul 12.
Fractures of the tibial tubercle are a relatively uncommon injury, representing 3% of all proximal tibia fractures and < 1% of all physeal fractures, primarily seen in the adolescent demographic. While recognition of the injury and its management is being more widely reported in the literature and recognized in the hospital setting, reports of its outcomes and complications have still been limited. This article provides an updated review of the outcomes and complications of tibial tubercle fractures.
Current research shows both radiographic outcomes, specifically osseous union, and functional outcomes, such as return to play and full knee range of motion, are excellent in patients treated either operatively or nonoperatively. Complication rates overall remain relatively low, with the most common complication being bursitis and hardware prominence and the most common associated injuries being patellar tendon avulsions and meniscus tears. With appropriate management, tibial tubercle fractures have an excellent overall outcome and a low complication rate. Although complications are uncommon, treating providers should be vigilant and recognize the signs of devastating complications resulting from acute vascular injuries or compartment syndrome. Further research should aim to analyze patients' experiences and satisfaction following treatment of this injury and examine the long-term functional and patient-reported outcomes.
胫骨结节骨折是一种相对罕见的损伤，占所有胫骨近端骨折的3%，占所有骨骺骨折的不到1%，主要见于青少年人群。虽然该损伤的识别及处理在文献中报道得越来越广泛，在医院环境中也得到了认可，但其治疗结果和并发症的报告仍然有限。本文对胫骨结节骨折的治疗结果和并发症进行了最新综述。
目前的研究表明，无论是手术治疗还是非手术治疗的患者，影像学结果，特别是骨愈合情况，以及功能结果，如恢复运动和膝关节完全活动范围，都非常好。总体并发症发生率仍然相对较低，最常见的并发症是滑囊炎和内固定物突出，最常见的相关损伤是髌腱撕脱和半月板撕裂。通过适当的处理，胫骨结节骨折总体预后良好，并发症发生率低。虽然并发症不常见，但治疗人员应保持警惕，识别急性血管损伤或骨筋膜室综合征导致的严重并发症的迹象。进一步的研究应旨在分析患者在该损伤治疗后的经历和满意度，并检查长期功能和患者报告的结果。
