Effectiveness comparison of pediatric tibial spine fractures fixation techniques. A systematic review

Tibial spine fractures are uncommon injuries, with a peak incidence between 8 and 14years of age. Meyers and McKeever typesII toIV are often managed surgically using a variety of techniques and fixation devices, depending on the fracture characteristics and the surgeon's expertise. The aim of this review is to analyze current evidence regarding functional outcomes across different surgical techniques. A systematic review was conducted using MeSH, Emtree, DeCS, Free Terms, and Boolean Operators across three databases. Data on trauma characteristics, patient demographics, and main outcomes for each fixation device were extracted and subjected to a descriptive analysis. From 88 records, 14 studies were included based on the eligibility criteria. Additionally, 2 studies were manually added from the references of included papers. The rate of arthrofibrosis was 15.9% for open surgery and 21% for arthroscopy-assisted techniques. A total of 6 different fixation methods were identified, with arthrofibrosis, residual laxity, nonunion, and range of motion limitations all reported in less than 10% of cases. Functional outcomes for all fixation methods were rated as good to excellent according to the Lysholm score. The main outcomes across different fixation devices are favorable and do not show significant differences. However, non-absorbable fixation methods were associated with a higher rate of reintervention. Larger, more robust epidemiological studies are needed to definitively recommend one fixation method over another.