Comparison of bioabsorbable screw versus metallic screw fixation for tibial tubercle fractures in adolescents: a retrospective cohort study.

BACKGROUND

Displaced tibial tubercle (TT) fractures in adolescents are typically treated with open reduction and internal fixation. While metallic screw (MS) fixation provides strong stability, it often results in a high incidence of postoperative screw head protrusion or irritation, leading to additional removal surgery. Bioabsorbable screw (BS) fixation presents an alternative that may avoid these issues, though its stability has not yet been extensively documented in the literature. This study aims to compare the efficacy of BS versus MS in the fixation of TT fractures.

METHODS

A retrospective analysis was conducted on adolescent patients with TT fractures who underwent surgical treatment from September 2015 to September 2023. Patients were divided into two groups based on the fixation method: The BS group and the MS group. Data collected included patient demographics, fracture details, treatment strategies, radiological and clinical rehabilitation outcomes, and postoperative complications. Knee joint function was evaluated using the Lysholm and Tegner scores. Statistical analysis was performed to identify differences between the variables of the two groups.

RESULTS

A total of 30 patients with 32 fractures were included, with 15 fractures in the BS group and 17 in the MS group. The average follow-up period was 42.1 (range: 12.0-109.5) months. The demographic characteristics, fracture details, and treatment strategies were comparable between the two groups. No significant differences were observed between the groups in fracture healing time, time to return to pre-injury activities, or knee joint function as assessed by the Lysholm and Tegner scores at the final follow-up. However, compared with the MS group, the BS group showed a shorter time to regain full range of motion (ROM) in the knee joint and experienced lower rates of postoperative hardware irritation and joint stiffness.

CONCLUSIONS

Both BS and MS fixations are safe and effective for treating adolescent TT fractures. BS fixation has the advantages of avoiding hardware irritation, facilitating earlier recovery of knee joint ROM, reducing the incidence of joint stiffness, and eliminating the need for additional removal surgery.

CLINICAL TRIAL NUMBER

Not applicable.