Sagittal Fragment Rotation and Ogden Type-I Classification Are Hallmarks of Combined Tibial Tubercle Fracture and...

Area of Science:

• Orthopedic surgery
• Pediatric orthopedics
• Traumatology

Background:

• Tibial tubercle fractures (TTFs) are uncommon, representing less than 3% of proximal tibial fractures.
• Combined TTFs and patellar tendon injuries (PTIs) are infrequent but significant occurrences.
• Identifying risk factors for combined TTF and PTI is crucial for effective management.

Purpose of the Study:

• To identify specific risk factors associated with combined tibial tubercle fractures and patellar tendon injuries.
• To enhance preoperative assessment and planning for patients with these complex injuries.

Main Methods:

• Retrospective review of 262 TTFs in 252 pediatric patients (2012-2023).
• Analysis of demographic data, operative details, radiographs, and injury patterns.
• Logistic regression models assessed risk factors including BMI, comminution, fragment rotation, epiphyseal union stage, and Ogden classification.

Main Results:

• 34 (13%) of 262 TTFs were combined with PTIs.
• Fragment rotation on lateral radiographs (OR 22.1) and Ogden Type-I classification (OR 10.2) were highly predictive of combined injuries.
• Fragment rotation and Ogden Type-I classification significantly increased the odds of a combined TTF and PTI.

Conclusions:

• Ogden classification and fragment rotation are critical for differentiating isolated TTFs from combined TTF with PTI.
• This study provides the first identified risk factors for combined TTF and PTI.
• Findings can assist surgeons in preoperative planning for combined injuries.