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Tibial spine fractures in children
1Children's Hospital of Eastern Ontario University of Ottawa, Canada.
Clinical Orthopaedics and Related Research
|June 1, 1990
Summary
Pediatric tibial eminence fractures, involving the anterior cruciate ligament, often show no clinical laxity. However, instrumental testing reveals subtle, measurable cruciate laxity despite successful fragment reattachment.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Sports medicine
Background:
- Intercondylar eminence fractures are common in children.
- These fractures involve the anterior cruciate ligament (ACL).
- Clinical assessment often misses subtle knee instability.
Purpose of the Study:
- To investigate residual cruciate laxity in pediatric patients after tibial eminence fractures.
- To compare clinical findings with instrumental laxity measurements.
- To evaluate treatment outcomes focusing on joint congruity versus ligament integrity.
Main Methods:
- Review of pediatric cases with tibial eminence fractures.
- Clinical examination for knee stability.
- Instrumental testing (e.g., arthrometry) to quantify laxity.
- Analysis of treatment methods (closed vs. open reduction).
Main Results:
- No significant clinical laxity was observed on follow-up, irrespective of treatment or injury type.
- Instrumental testing revealed measurable residual laxity in a significant proportion of knees.
- Treatment focused on fragment reattachment and joint congruity.
Conclusions:
- Pediatric tibial eminence fractures may result in subclinical anterior cruciate ligament laxity.
- Instrumental testing is crucial for detecting subtle instability missed by clinical exams.
- Current treatment paradigms prioritize bony healing and joint congruity over complete ACL restoration.