Skip to main content

Advertisement

SpringerLink
Log in

Meniscal injuries in skeletally immature children with tibial eminence fractures. Systematic review of literature

  • Review
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

Although the mechanisms of injury are similar to ACL rupture in adults, publications dealing with meniscal lesions resulting from fractures of the intercondylar eminence in children are much rarer. The main objective was to measure the frequency of meniscal lesions associated with tibial eminence fractures in children. The second question was to determine whether there is any available evidence on association between meniscal tears diagnostic method, and frequencies of total lesions, total meniscal lesions, and total entrapments.

Methods

A comprehensive literature search was performed using PubMed and Scopus. Articles were eligible for inclusion if they reported data on intercondylar tibial fracture, or tibial spine fracture, or tibial eminence fracture, or intercondylar eminence fracture. Article selection was performed in accordance with the PRISMA guidelines.

Results

In total, 789 studies were identified by the literature search. At the end of the process, 26 studies were included in the final review. This systematic review identified 18.1% rate of meniscal tears and 20.1% rate of meniscal or IML entrapments during intercondylar eminence fractures. Proportion of total entrapments was significantly different between groups (17.8% in the arthroscopy group vs. 6.2% in the MRI group; p < .0001). Also, we found 20.9% of total associated lesions in the arthroscopy group vs. 26.1% in the MRI group (p = .06).

Conclusion

Although incidence of meniscal injuries in children tibial eminence fractures is lower than that in adults ACL rupture, pediatric meniscal tears and entrapments need to be systematically searched. MRI does not appear to provide additional information about the entrapment risk if arthroscopy treatment is performed. However, pretreatment MRI provides important informations about concomitant injuries, such as meniscal tears, and should be mandatory if orthopaedic treatment is retained. MRI modalities have yet to be specified to improve the diagnosis of soft tissues entrapments.

Study design

Systematic review of the literature

Registration

PROSPERO N° CRD42021258384

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

N/A.

References

  1. Coyle C, Jagernauth S, Ramachandran M (2014) Tibial eminence fractures in the paediatric population: A systematic review. J Child Orthop 8:149–159

    Article  PubMed  PubMed Central  Google Scholar 

  2. Lafrance RM, Giordano B, Goldblatt J et al (2010) Pediatric tibial eminence fractures: Evaluation and management. J Am Acad Orthop Surg 18:395–405

    Article  PubMed  Google Scholar 

  3. Bram JT, Aoyama JT, Mistovich RJ et al (2020) Four risk factors for arthrofibrosis in tibial spine fractures: A national 10-site multicenter study. Am J Sports Med 48:2986–2993

    Article  PubMed  Google Scholar 

  4. Iborra JP, Mazeau P, Louahem D et al (1999) fractures of the intercondylar eminence of the tibia in children. Apropos of 25 cases with a 1–20 year follow up. Rev Chir Orthop Reparatrice Appar Mot. 85(6):563–73

    CAS  PubMed  Google Scholar 

  5. Kocher MS, Micheli LJ, Gerbino P et al (2003) Tibial eminence fractures in children: Prevalence of meniscal entrapment. Am J Sports Med 31:404–407

    Article  PubMed  Google Scholar 

  6. Woo SL, Hollis JM, Adams DJ et al (1991) Tensile properties of the human femur-anterior cruciate ligament-tibia complex. The effects of specimen age and orientation. Am J Sports Med 19:217–225

    Article  CAS  PubMed  Google Scholar 

  7. Wiley JJ, Baxter MP (1990) Tibial spine fractures in children. Clin Orthop Relat Res 255:54–60

    Article  Google Scholar 

  8. Meyers MH, Mc KF (1959) Fracture of the intercondylar eminence of the tibia. J Bone Joint Surg Am 41-A:209–20 (discussion 20-2)

    Article  CAS  PubMed  Google Scholar 

  9. Zaricznyj B (1977) Avulsion fracture of the tibial eminence: Treatment by open reduction and pinning. J Bone Joint Surg Am 59:1111–1114

    Article  CAS  PubMed  Google Scholar 

  10. Gans I, Baldwin KD, Ganley TJ (2014) Treatment and management outcomes of tibial eminence fractures in pediatric patients: A systematic review. Am J Sports Med 42:1743–1750

    Article  PubMed  Google Scholar 

  11. Yoon KH, Yoo JH, Kim KI (2011) Bone contusion and associated meniscal and medial collateral ligament injury in patients with anterior cruciate ligament rupture. J Bone Joint Surg Am 93:1510–1518

    Article  PubMed  Google Scholar 

  12. Pike AN, Patzkowski JC, Bottoni CR (2019) Meniscal and chondral pathology associated with anterior cruciate ligament injuries. J Am Acad Orthop Surg 27:75–84

    Article  PubMed  Google Scholar 

  13. Park JH, Park HJ, Lee SY et al (2020) Intra-articular and meniscal pathology according to anterior cruciate ligament injury pattern: Both-bundle tear or selective bundle tear. Acta Radiol 61:644–650

    Article  PubMed  Google Scholar 

  14. Shimberg JL, Aoyama JT, Leska TM et al (2020) Tibial spine fractures: How much are we missing without pretreatment advanced imaging? A multicenter study. Am J Sports Med 48:3208–3213

    Article  PubMed  Google Scholar 

  15. Johnson AC, Wyatt JD, Treme G et al (2014) Incidence of associated knee injury in pediatric tibial eminence fractures. J Knee Surg 27:215–219

    PubMed  Google Scholar 

  16. Burstein DB, Viola A, Fulkerson JP (1988) Entrapment of the medial meniscus in a fracture of the tibial eminence. Arthroscopy 4:47–50

    Article  CAS  PubMed  Google Scholar 

  17. Falstie-Jensen S, Sondergard Petersen PE (1984) Incarceration of the meniscus in fractures of the intercondylar eminence of the tibia in children. Injury 15:236–238

    Article  CAS  PubMed  Google Scholar 

  18. Rhodes JT, Cannamela PC, Cruz AI et al (2018) Incidence of meniscal entrapment and associated knee injuries in tibial spine avulsions. J Pediatr Orthop 38:e38–e42

    Article  PubMed  Google Scholar 

  19. Mitchell JJ, Sjostrom R, Mansour AA et al (2015) Incidence of meniscal injury and chondral pathology in anterior tibial spine fractures of children. J Pediatr Orthop 35:130–135

    Article  PubMed  Google Scholar 

  20. Feucht MJ, Brucker PU, Camathias C et al (2017) Meniscal injuries in children and adolescents undergoing surgical treatment for tibial eminence fractures. Knee Surg Sports Traumatol Arthrosc 25:445–453

    Article  PubMed  Google Scholar 

  21. Chandler JT, Miller TK (1995) Tibial eminence fracture with meniscal entrapment. Arthroscopy 11:499–502

    Article  CAS  PubMed  Google Scholar 

  22. Menge TJ, Chahla J, Mitchell JJ et al (2018) Avulsion of the anterior lateral meniscal root secondary to tibial eminence fracture. Am J Orthop (Belle Mead NJ) 47:5

    Google Scholar 

  23. Callanan M, Allen J, Flutie B et al (2019) Suture versus screw fixation of tibial spine fractures in children and adolescents: A comparative study. Orthop J Sports Med 7:2325967119881961

    Article  PubMed  PubMed Central  Google Scholar 

  24. Casalonga A, Bourelle S, Chalencon F et al (2010) Tibial intercondylar eminence fractures in children: The long-term perspective. Orthop Traumatol Surg Res 96:525–530

    Article  CAS  PubMed  Google Scholar 

  25. Chotel F, Raux S, Accadbled F et al (2016) Cartilaginous tibial eminence fractures in children: Which recommendations for management of this new entity? Knee Surg Sports Traumatol Arthrosc 24:688–696

    Article  PubMed  Google Scholar 

  26. Furlan D, Pogorelic Z, Biocic M et al (2010) Pediatric tibial eminence fractures: Arthroscopic treatment using k-wire. Scand J Surg 99:38–44

    Article  CAS  PubMed  Google Scholar 

  27. Kocher MS, Foreman ES, Micheli LJ (2003) Laxity and functional outcome after arthroscopic reduction and internal fixation of displaced tibial spine fractures in children. Arthroscopy 19:1085–1090

    Article  PubMed  Google Scholar 

  28. Kristinsson J, Elsoe R, Jensen HP et al (2021) Satisfactory outcome following arthroscopic fixation of tibial intercondylar eminence fractures in children and adolescents using bioabsorbable nails. Arch Orthop Trauma Surg 141:1945–1951

    Article  PubMed  Google Scholar 

  29. Liljeros K, Werner S, Janarv PM (2009) Arthroscopic fixation of anterior tibial spine fractures with bioabsorbable nails in skeletally immature patients. Am J Sports Med 37:923–928

    Article  PubMed  Google Scholar 

  30. Louis ML, Guillaume JM, Launay F et al (2008) Surgical management of type ii tibial intercondylar eminence fractures in children. J Pediatr Orthop B 17:231–235

    Article  PubMed  Google Scholar 

  31. Mah JY, Adili A, Otsuka NY et al (1998) Follow-up study of arthroscopic reduction and fixation of type iii tibial-eminence fractures. J Pediatr Orthop 18:475–477

    Article  CAS  PubMed  Google Scholar 

  32. Mayo MH, Mitchell JJ, Axibal DP et al (2019) Anterior cruciate ligament injury at the time of anterior tibial spine fracture in young patients: An observational cohort study. J Pediatr Orthop 39:e668–e673

    Article  PubMed  Google Scholar 

  33. Momaya AM, Read C, Steirer M et al (2018) Outcomes after arthroscopic fixation of tibial eminence fractures with bioabsorbable nails in skeletally immature patients. J Pediatr Orthop B 27:8–12

    Article  PubMed  Google Scholar 

  34. Najdi H, Thevenin-Lemoine C, Sales de Gauzy J et al (2016) Arthroscopic treatment of intercondylar eminence fractures with intraepiphyseal screws in children and adolescents. Orthop Traumatol Surg Res 102:447–451

    Article  CAS  PubMed  Google Scholar 

  35. Patel NM, Park MJ, Sampson NR et al (2012) Tibial eminence fractures in children: Earlier posttreatment mobilization results in improved outcomes. J Pediatr Orthop 32:139–144

    Article  PubMed  Google Scholar 

  36. Perugia D, Basiglini L, Vadala A et al (2009) Clinical and radiological results of arthroscopically treated tibial spine fractures in childhood. Int Orthop 33:243–248

    Article  CAS  PubMed  Google Scholar 

  37. Shea KG, Grimm NL, Laor T et al (2011) Bone bruises and meniscal tears on mri in skeletally immature children with tibial eminence fractures. J Pediatr Orthop 31:150–152

    Article  PubMed  Google Scholar 

  38. Shepley RW (2004) Arthroscopic treatment of type iii tibial spine fractures using absorbable fixation. Orthopedics 27:767–769

    Article  PubMed  Google Scholar 

  39. Shin CH, Lee DJ, Choi IH et al (2018) Clinical and radiological outcomes of arthroscopically assisted cannulated screw fixation for tibial eminence fracture in children and adolescents. BMC Musculoskelet Disord 19:41

    Article  PubMed  PubMed Central  Google Scholar 

  40. Wiegand N, Naumov I, Vamhidy L et al (2014) Arthroscopic treatment of tibial spine fracture in children with a cannulated herbert screw. Knee 21:481–485

    Article  CAS  PubMed  Google Scholar 

  41. Wilfinger C, Castellani C, Raith J et al (2009) Nonoperative treatment of tibial spine fractures in children-38 patients with a minimum follow-up of 1 year. J Orthop Trauma 23:519–524

    Article  PubMed  Google Scholar 

  42. Xu X, Liu Z, Wen H et al (2017) Arthroscopic fixation of pediatric tibial eminence fractures using suture anchors: A mid-term follow-up. Arch Orthop Trauma Surg 137:1409–1416

    Article  PubMed  Google Scholar 

  43. Prodromidis AD, Drosatou C, Thivaios GC et al (2021) Timing of anterior cruciate ligament reconstruction and relationship with meniscal tears: A systematic review and meta-analysis. Am J Sports Med 49:2551–2562

    Article  PubMed  Google Scholar 

  44. Korpershoek JV, de Windt TS, Vonk LA et al (2020) Does anterior cruciate ligament reconstruction protect the meniscus and its repair? A systematic review. Orthop J Sports Med 8:2325967120933895

    Article  PubMed  PubMed Central  Google Scholar 

  45. Ferrari MB, Murphy CP, Gomes JLE (2019) Meniscus repair in children and adolescents: A systematic review of treatment approaches, meniscal healing, and outcomes. J Knee Surg 32:490–498

    Article  PubMed  Google Scholar 

  46. Liechti DJ, Constantinescu DS, Ridley TJ et al (2019) Meniscal repair in pediatric populations: A systematic review of outcomes. Orthop J Sports Med 7:2325967119843355

    Article  PubMed  PubMed Central  Google Scholar 

  47. Brunner S, Vavken P, Kilger R et al (2016) Absorbable and non-absorbable suture fixation results in similar outcomes for tibial eminence fractures in children and adolescents. Knee Surg Sports Traumatol Arthrosc 24:723–729

    Article  PubMed  Google Scholar 

  48. Hirschmann MT, Mayer RR, Kentsch A et al (2009) Physeal sparing arthroscopic fixation of displaced tibial eminence fractures: A new surgical technique. Knee Surg Sports Traumatol Arthrosc 17:741–747

    Article  PubMed  Google Scholar 

  49. Ishibashi Y, Tsuda E, Sasaki T et al (2005) Magnetic resonance imaging aids in detecting concomitant injuries in patients with tibial spine fractures. Clin Orthop Relat Res. 434:207–12

    Article  Google Scholar 

  50. Lowe J, Chaimsky G, Freedman A et al (2002) The anatomy of tibial eminence fractures: Arthroscopic observations following failed closed reduction. J Bone Joint Surg Am 84:1933–1938

    Article  CAS  PubMed  Google Scholar 

  51. Newman JT, Carry PM, Terhune EB et al (2015) Factors predictive of concomitant injuries among children and adolescents undergoing anterior cruciate ligament surgery. Am J Sports Med 43:282–288

    Article  PubMed  Google Scholar 

  52. Shapiro MS, Freedman EL (1995) Allograft reconstruction of the anterior and posterior cruciate ligaments after traumatic knee dislocation. Am J Sports Med 23:580–587

    Article  CAS  PubMed  Google Scholar 

  53. Archibald-Seiffer N, Jacobs J Jr, Zbojniewicz A et al (2015) Incarceration of the intermeniscal ligament in tibial eminence injury: A block to closed reduction identified using mri. Skeletal Radiol 44:717–721

    Article  PubMed  Google Scholar 

  54. Hayes JM, Masear VR (1984) Avulsion fracture of the tibial eminence associated with severe medial ligamentous injury in an adolescent. A case report and literature review. Am J Sports Med 12:330–333

    Article  CAS  PubMed  Google Scholar 

  55. Molander ML, Wallin G, Wikstad I (1981) Fracture of the intercondylar eminence of the tibia: A review of 35 patients. J Bone Joint Surg Br 63-B:89–91

    Article  CAS  PubMed  Google Scholar 

  56. Vocke AK, Vocke AR (2002) Cartilaginous avulsion fracture of the tibial spine. Orthopedics 25:1293–1294

    Article  CAS  PubMed  Google Scholar 

  57. Laurens M, Cavaignac E, Fayolle H et al (2021) The accuracy of mri for the diagnosis of ramp lesions. Skeletal Radiol 51(3):525–533

    Article  PubMed  Google Scholar 

Download references

Funding

There is no funding source.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Clinique Porte Océane, CESAL F-85340, Les Sables d’Olonne, France

    Mathieu Severyns & Jean-Baptiste Marchand

  2. Department of Orthopaedic Surgery, University Hospital of Lariboisière, 75010, Paris, France

    Guillaume Anthony Odri

  3. Pprime Institut UP 3346, CNRS, University of Poitiers, 86000, Poitiers, France

    Tanguy Vendeuvre & Arnaud Germaneau

  4. Department of Clinical Research and Innovation, University Hospital of Martinique, 97200, Fort-de-France, France

    Moustapha Dramé

Authors
  1. Mathieu Severyns
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Guillaume Anthony Odri
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tanguy Vendeuvre
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jean-Baptiste Marchand
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Arnaud Germaneau
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Moustapha Dramé
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

○ MS: Collected the data, wrote the paper.

○ GAO: Contributed data and analysis tools.

○ TV: Conceived and designed the analysis.

○ JBM: Revision of the manuscript.

○ AG: Collected the data.

○ MD: Performed the analysis.

Corresponding author

Correspondence to Mathieu Severyns.

Ethics declarations

Ethical approval

NA (systematic review of the literature)

Consent to participate

N/A.

Consent to publish

All authors consent to publish in the journal International Orthopaedics.

Informed consent

N/A (systematic review of the literature)

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Severyns, M., Odri, G.A., Vendeuvre, T. et al. Meniscal injuries in skeletally immature children with tibial eminence fractures. Systematic review of literature. International Orthopaedics (SICOT) 47, 2439–2448 (2023). https://doi.org/10.1007/s00264-023-05787-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-023-05787-w

Keyword

Search

Navigation