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Arthroscopic tibial spine fracture fixation: Novel techniques.

ABSTRACT: Proper knee kinematics depends upon the integrity of ACL at its femoral and medial tibial spine attachments. Tibial spine fractures disrupt this complex and if untreated can lead to pain, instability and functional limitation. So proper diagnosis and early treatment of tibial spine avulsion fracture is important. Tibial spine fractures are often associated with intra-articular injuries which are more common in adults. Diagnosis and treatment of these associated injuries along with proper fixation of tibial spine fractures are essential. Surgical options for tibial spine fractures include reduction and fixation through arthrotomy or arthroscopic technique. Arthroscopic technique is now more popular as it allows accurate diagnosis and treatment of associated injuries, reduction and fixation of all types of tibial spine fractures and reduced morbidity compared with open techniques.

SUBMITTER: R R

PROVIDER: S-EPMC5990123 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

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Arthroscopic tibial spine fracture fixation: Novel techniques.

R Rajanish R Jaseel Mohammed M Murugan Chandhan C Kumaran C M CM

Journal of orthopaedics 20180214 2

Proper knee kinematics depends upon the integrity of ACL at its femoral and medial tibial spine attachments. Tibial spine fractures disrupt this complex and if untreated can lead to pain, instability and functional limitation. So proper diagnosis and early treatment of tibial spine avulsion fracture is important. Tibial spine fractures are often associated with intra-articular injuries which are more common in adults. Diagnosis and treatment of these associated injuries along with proper fixatio ...[more]

PMID: 29881156

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Project description:PurposeTo determine trends in arthroscopic-assisted tibial plateau fracture fixation (AATPFF), to evaluate trends in the overall rate of tibial plateau fracture fixation, and to compare postoperative complications between AATPFF and traditional tibial plateau fixation.MethodsA retrospective review of patients undergoing AATPFF and traditional tibial plateau fixation was conducted using the Humana Inc. administrative database from 2007 to 2016. A 1:1 propensity match was utilized to match patients in the 2 study groups based on age, sex, obesity, diabetes, hypertension, chronic obstructive pulmonary disease, depression or anxiety, and smoking history. Postoperative complications were grouped as minor medical complications, major medical complications, surgical complications, emergency department visits, and reoperation. Linear regression analysis was used to assess trends and Pearson's χ2 test was used to compare postoperative complications with statistical significance defined as P < .05.ResultsIn total, 522 patients underwent AATPFF and 3920 patients underwent traditional tibial plateau fracture fixation. There was a 4-fold increase in the use of AATPFF over the study period (P = .0173). Similarly, there was an increase in the utilization of traditional tibial plateau fracture fixation, although to a lesser extent (1.33-fold). After propensity matching, the traditional fixation group demonstrated significantly higher rates of minor medical complications (8.2% vs 2.7%, P = .0002), major medical complications (9.9% vs 4.6%, P = .0018), surgical complications (13.2% vs 2.7%, P < .0001), and emergency department visits (21.4% vs 13.5%, P < .0001) within 90 days of surgery compared with the AATPFF group. There was no difference in reoperation rates within 90 days between the 2 groups (2.9% vs 3.6%, P = .85).ConclusionsThe incidence of tibial plateau fracture fixation is increasing, however, use of AATPFF is increasing at a faster rate compared to traditional techniques. Furthermore, the addition of knee arthroscopy to fracture fixation does not increase the risk of complication, reoperation, or emergency department visit within 90 days.Level of evidenceIII, retrospective matched cohort.

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Arthroscopic tibial spine fracture fixation: Novel techniques.

Publications

Arthroscopic tibial spine fracture fixation: Novel techniques.

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