Abstract / Summary
Abstract Background In Norway, no previous studies have investigated the incidence or mechanism of injury of tibial spine fractures in children. The aim of this study was to describe the treatment outcomes of patients treated for a tibial spine fracture at Akershus University Hospital between 2010 and 2020. Methods This was a retrospective cohort study with cross-sectional follow-up including children (boys ≤ 16 years and girls ≤ 14 years old at time of injury) treated for tibial spine fractures at Akershus University Hospital between 2010 and 2020. The included patients were invited to a clinical follow-up visit with clinical examination of knee laxity testing (Lachman test and portable Rolimeter arthrometer measurements) and assessment of patient reported outcome measures (PROMs), including Pediatric International Knee Documentation Committee Subjective Knee Evaluation Form (pedi-IKDC) and Hospital for Special Surgery Pediatric Functional Activity Brief Scale (HSS Pedi-FABS). The primary outcome of this study was to describe outcomes after a tibial spine fracture while secondary observations included injury mechanisms, additional injuries, treatment, reinjuries and clinical examination of knee laxity. Results Twenty-four patients were included in this study. 17 (70.8%) were male and median age was 12 years old (range 6 to 16 years). Alpine skiing was the injury mechanism in 33.3% of cases. 14 of the patients were treated surgically. 6 patients (25%) had additional intraarticular injury at baseline, 3 patients later developed an anterior cruciate ligament injury, and 2 patients sustained a contralateral tibial spine fracture. The median pedi-IKDC score was 92,9, and the median HSS pedi-FABS score was 14,5. Most of the patients had differences in Rolimeter measurements between the injured and uninjured knee, with the largest side-to-side difference being 5 mm and a median difference of 1 mm. Conclusion We found increased laxity measurements with Rolimeter, but the clinical significance of this finding is uncertain. In our patient cohort, PROMs were acceptable compared with normative values. Due to the rarity of this type of injury, there is a need for a multicenter prospective study on tibial spine fractures in children. Level of evidence Level 4.