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Arthroscopic Treatment of Tibial Spine Fractures

Living reference work entry
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Abstract

Tibial spine fractures are an avulsion of the attachment site of the anterior cruciate ligament on the tibia. They are a relatively rare type of fracture that children (ages 8–14 most commonly) may sustain. They are typically cited at less than 2% of all knee injuries in the pediatric population. The mechanism of injury is classically taught as a fall from a bike landing on a hyperflexed knee. More recent studies have supported that the mechanism of injury is similar to that of adult style anterior cruciate ligament (ACL) injury. This injury represents a failure of the chondroepiphysis. The ACL in children has a greater strength to failure than to the bone to which it is attached. It should be remembered that although the obvious injury happens at the tibial spine, a stretching injury to the anterior cruciate ligament itself can also occur. Tibial spine fractures are classified by the Myers/McKeaver classification: type 1 is minimal displacement, type 2 is anterior half of the fractured tibial spine is elevated with intact posterior hinge, and type 3 is complete avulsion of the tibial spine. A type 4 was added later which is complete displacement with rotation.

Keywords

Anterior Cruciate Ligament Anterior Horn Accessory Portal Cannulated Screw Tibial Spine 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References and Suggested Reading

  1. Edmonds E, Fornari E, Dashe J, Roocroft J, King M, Pennock A (2015) Results of displaced pediatric tibial spine fractures: a comparison between open, arthroscopic, and closed management. J Pediatr Orthop 35:651–656CrossRefPubMedGoogle Scholar
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  4. Mitchell J, Sjostrom R, Mansour A, Irion B, Hotchkiss M, Terhune B, Carry P, Stewart J, Vidal A, Rhodes J (2015) Incidence of meniscal injury and chondral pathology in anterior tibial spine fractures of children. J Pediatr Orthop 35:130–135CrossRefPubMedGoogle Scholar
  5. Shea K, Grimm N, Loar T, Wall E (2011) Bone bruises and meniscal tears on MRI in skeletally immature children with tibial eminence fractures. J Pediatr Orthop 31:150–152CrossRefPubMedGoogle Scholar

Authors and Affiliations

  1. 1.Department of Pediatric OrthopedicsNemours Children’s Specialty CareJacksonvilleUSA

Section editors and affiliations

  • Eric D. Shirley
    • 1
  1. 1.OrthopaedicsNemours Children's ClinicJacksonvilleUSA

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