Modifiable Risk Factors for Complications Following Surgical Treatment of Tibial Tubercle Fracture

Area of Science:

• Orthopedic surgery
• Pediatric trauma
• Sports medicine

Background:

• Tibial tubercle fractures (TTF) are common in athletic adolescents, requiring surgical fixation.
• Current surgical techniques and postoperative protocols for TTF vary, with limited understanding of outcome determinants.
• This study investigates the impact of surgical technique and rehabilitation on postoperative complications in TTF.

Purpose of the Study:

• To identify factors influencing postoperative complications in surgically treated tibial tubercle fractures.
• To compare outcomes between accelerated and conservative rehabilitation protocols.
• To analyze the association between specific surgical decisions and complication rates.

Main Methods:

• Retrospective review of 183 surgically treated TTF cases (2010-2022) at a pediatric trauma center.
• Patients classified into 'accelerated' (rehab within 21 days) or 'conservative' groups.
• Complications graded using the Clavien-Dindo classification; logistic regression used for analysis.

Main Results:

• Overall complication rate was 44.3%, with 33.3% being grade II or III.
• Symptomatic implant was the most frequent complication (19.7%).
• Female sex, postoperative casting, and lower BMI were associated with higher complication rates; distal periosteal repair was associated with lower rates.

Conclusions:

• Postoperative casting and distal periosteal repair are modifiable factors influencing TTF complication risk.
• Standardizing care and implementing accelerated rehabilitation protocols may enhance patient outcomes.
• Further research into optimizing rehabilitation strategies for TTF is warranted.