Tibial spine fractures in children

Fractures of the intercondylar eminence of the tibia are not uncommon in the pediatric age group. This eminence consists of two projecting tibial spines: the anterior cruciate ligament being attached to the medial one. In spite of an avulsion of this bony fragment and its attached ligament, cruciate laxity does not appear to be a significant clinical finding on follow-up examination, regardless of the type of fracture, method of treatment, or mode of injury. Computed instrumental testing of these knees, however, revealed measurable degrees of residual cruciate laxity in spite of the absence of patient symptoms. In the pediatric age group, treatment by closed or open methods is directed toward reattachment of the loose fragment and achievement of some degree of joint congruity rather than restoration of cruciate integrity.