SCREW VS. SUTURE FIXATION FOR TIBIAL EMINENCE FRACTURES: A META-ANALYSIS

Area of Science:

• Orthopedic surgery
• Pediatric orthopedics

Background:

• Tibial spine fractures are common in children.
• Fixation methods include screw and suture techniques.

Purpose of the Study:

• Compare functional and surgical outcomes of screw versus suture fixation in pediatric tibial spine fractures.

Main Methods:

• Systematic review following PRISMA guidelines.
• Included four retrospective cohort studies with 186 patients.
• Assessed postoperative knee function, operative time, reoperation, implant removal, joint instability, and return to sport.

Main Results:

• No significant difference in knee function (SMD = -0.07; p = 0.702).
• Screw fixation had shorter operative time (MD = -9.17 minutes; p < 0.001).
• Screw fixation showed higher reoperation (RR = 1.78; p = 0.040) and implant removal rates (RR = 6.25; p = 0.040).
• No differences in joint instability (RR = 0.90; p = 0.770) or return to sport (RR = 1.83; p = 0.190).
• Potential publication bias identified.

Conclusions:

• Both screw and suture fixation provide similar functional outcomes for pediatric tibial spine fractures.
• Screw fixation is associated with reduced operative time but increased complication risks.
• Level of evidence IIa; systematic review of cohort studies.