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OUTCOME OF FRACTURES OF THE ANTERIOR TIBIAL SPINE IN SKELETALLY MATURE PATIENTS



Abstract

Purpose: To determine the outcome following anterior tibial spine avulsion in skeletally mature patients.

Summary: The study group comprised 83 knees with anterior tibial spine avulsion. The mean age of patients at injury was 35. Twenty knees with displaced tibial spine fractures were treated with fixation of the tibial spine and 63 patients with undisplaced or minimally displaced fractures were treated non-operatively.

Twenty two percent of the non operatively managed knees developed symptomatic instability and 10% of knees treated with tibial spine fixation developed instability (p=0.22). Stiffness was more common in knees treated with tibial spine fixation than in knees managed nonoperatively (60% vs 19%, p < 0.0005). There was a tendency for increased stiffness in older patients treated with surgical fixation of the tibial spine.

Conclusion: Tibial spine fracture in skeletally mature patients is associated with significant risk of knee stiffness and instability.

Correspondence should be addressed to: BASK c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.