Articles Vol. 65 No. CĐ11- HN Chấn thương Chỉnh hình-TPHCM 02/12/2024

18. RESULTS OF SURGICAL TREATMENT FOR PROXIMAL TIBIAL EPIPHYSIS FRACTURES IN CHILDREN

Vo Quang Dinh Nam1,2, Hoang Pham Nhat Quang1,2
1 Hospital for Traumatology and Orthopaedics
2 Bệnh viện Chấn thương Chỉnh hình Thành phố Hồ Chí Minh
Corresponding author: namvqd@gmail.com
DOI: 10.52163/yhc.v65iCD11.1753
34 Views
11 Downloads
Keywords
proximal tibial epiphysis fracture (PTEF) tibial tubercle avulsion (TTA) direct injury mechanism indirect injury mechanism
Abstract

Background: Proximal tibial epiphysis fractures are challenged for total approach. Management remains debated.

Purposes: evaluate the results of surgical treatment.

Methods: Retrospective study of 29 cases of proximal tibial epiphysis fracture/tibial tubercle avulsion managed by closed or open reduction and fixation with pinning, screw and plate from January 2016 to December 2017. The fractures were classified according to Salter and San Diego. The functional evaluation was at the final follow-up of a minimum of 18 months.

Results: Tibial tubercle fracture (72%) was more frequent than proximal tibial epiphysis fracture (28%); age of TTA was older than PTEF (p<0.05); dominant injury mechanism was indirect for TTA (76%), but direct for PTEF (75%). TTA was mostly fixed by screws (95.2%), whereas PTEF was never fixed by unique screws. The length of stay for PTEF was longer than for TTA (p<0.05). Average follow-up was 30.5 months (21-41 months); good functional recovery was for both types of fracture.

Conclusion: Injury mechanism was indirectly dominant for TTA, and directly for PTEF with risk of compartment syndrome and vascular injury. However, good functional recovery was both types of fracture at final follow-up.

References
[1]
A. D. Perron et al. (2002), "Orthopedic pitfalls in the ED: pediatric growth plate injuries", Am J Emerg Med. Vol 20, (1), tr. 50-54. Google Scholar
[2]
S. W. Hamilton, P. H. Gibson (2006), "Simultaneous bilateral avulsion fractures of the tibial tuberosity in adolescence: A case report and review of over 50 years of literature", Knee. Vol 13, (5), tr. 404-407. Google Scholar
[3]
L. C. Le, R. W. Blum (2013), "Road traffic injury among young people in Vietnam: evidence from two rounds of national adolescent health surveys, 2004-2009", Glob Health Action. Vol 6, tr. 1-9. Google Scholar
[4]
D. C. Neuschwander et al. (1992), "Tibial tuberosity fracture associated with compartment syndrome", Orthopedics. Vol 15, (9), tr. 1109-1111. Google Scholar
[5]
N. K. Pandya et al. (2012), "Tibial tubercle fractures: complications, classification, and the need for intra-articular assessment", J Pediatr Orthop. Vol 32, (8), tr. 749-759. Google Scholar
[6]
J. A. Ogden et al. (1980), "Fractures of the tibial tuberosity in adolescents", J Bone Joint Surg Am. Vol 62, (2), tr. 205-215. Google Scholar
[7]
Phạm Hồng Thái (2003), Khảo sát tình hình gãy bong sụn tiếp hợp ở xương dài lớn tứ chi, Luận án Thạc sĩ, Khoa Y, Đại Học Y Dược TP. HCM, 2003. Google Scholar
[8]
S. S. Burkhart, H. A. Peterson (1979), "Fractures of the proximal tibial epiphysis", J Bone Joint Surg Am. Vol 61, (7), tr. 996-1002. Google Scholar
[9]
Anthony I. Riccio et al. (2019), "Functional Outcomes Following Operative Treatment of Tibial Tubercle Fractures". Vol 39, (2), tr. e108-e113. Google Scholar
[10]
E. Gautier et al. (1998), "Growth disturbances after injuries of the proximal tibial epiphysis", Arch Orthop Trauma Surg. Vol 118, (1-2), tr. 37- 41. Google Scholar
[11]
Kali Tileston, Steven Frick (2018), "Proximal Tibial Fractures in the Pediatric Population", J Knee Surg. Vol 31, (06), tr. 498-503. Google Scholar