Is Fixation Strategy Associated With Complication Risk in Ogden Type IV Tibial Tubercle Avulsion Fractures? A...

Area of Science:

• Orthopedic surgery
• Traumatology
• Skeletal reconstruction

Background:

• Ogden Type IV tibial tubercle avulsion fractures (TTAFs) are rare and complex injuries.
• Optimal surgical treatment for Type IV TTAFs remains debated due to multiplanar physeal involvement.
• Existing studies suggest higher complication rates and varied fixation for Type IV TTAFs.

Purpose of the Study:

• To analyze fixation constructs used in surgically managed Ogden Type IV TTAFs.
• To identify factors associated with postoperative complications in these fractures.

Main Methods:

• Retrospective multicenter cohort study (2007-2022) of surgically treated Ogden Type IV TTAFs.
• Exclusion of nonoperatively managed patients.
• Analysis of demographics, injury characteristics, fixation strategies, and complications; Fisher exact tests for comparisons.

Main Results:

• Eighty-nine patients with Type IV TTAFs were analyzed.
• Screw-only constructs were most common (80.9%), followed by pins/hybrid (10.1%) and plates (9.0%).
• Major complications were significantly lower with screw-only constructs (6.9%) versus other fixation types (35.3%; P = .005).

Conclusions:

• A variety of fixation options are effective for Ogden Type IV TTAFs.
• Screw-only constructs demonstrated the lowest rate of major postoperative complications.
• Implant irritation was the most frequent complication, but overall outcomes were favorable.