| Autor: |
Theodore Ganley, Henry Ellis, Jilan Shimberg, Aristides Cruz, Julien Aoyama, Peter Fabricant, Daniel Green, Benjamin Johnson, Indranil Kushare, R. Jay Lee, Scott McKay, Todd Milbrandt, Neeraj Patel, Jason Rhodes, Brant Sachleben, Jessica Traver, Justin Mistovich, Gregory Schmale, Tomasina Leska, Danielle Cook, Yi-Meng Yen, Shannon McGurty |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
Orthopaedic Journal of Sports Medicine. 10:2325967121S0058 |
| ISSN: |
2325-9671 |
| Popis: |
Objectives: Operative treatment of displaced tibial spine fractures consists of suture or screw fixation to reduce the fragment in addition to restoring tension of the ACL. In some instances, the reduction is not anatomic, but it is unknown whether this impacts healing, range of motion, or laxity. The purpose of this study is to determine if residual displacement of the anterior portion of a tibial spine fragment affects the range of motion or laxity in post-operative and non-operatively treated tibial spine patients and to assess if anterior lip displacement (ALD) predicts complications in these patients. Methods: Data was gathered from an institutional review board-approved multicenter retrospective cohort of patients treated for tibial spine fractures between January 1, 2000, and January 31, 2019, at 10 institutions. Patients younger than 25 years of age with tibial spine fractures were included. Five-hundred seventy-eight patients were included in the cohort, excluding patients with missing data. Range of motion and ALD measurements were summarized and compared from pre-treatment to the patient’s final visit. ALD measurements were categorized into four groups: 0 to 5mm, poor. Results: Eighty-two percent (474/578) of patients had an operative treatment while only 18% of patients (104/578) had a non-operative treatment. There was a higher proportion of patients who had a positive Lachman test in the non-operative group (12%; 12/104) compared to the operative group (4%; 18/474; p=0.001). The surgical group had a median time of 3.4 months from surgery (range, 0.10 to 91.86 months) to final displacement measurement, while the non-operative group had a median time of 2.6 months from initial treatment to final displacement measurement (range, 0.07 to 61.37 months). Overall, there was no significant difference in the final range of motion measurements between these groups. The median anterior lip displacement measurement prior to treatment was 6.1mm and decreased to 0.7mm after treatment (pConclusions: Operative patients demonstrated greater ACL stability than the non-operative group, but had more complications and reoperations, independent from ALD. While ALD measurements of ‘fair’, ‘good’, and ‘poor’ all resulted in some loss of range of motion, this was of minimal clinical significance in patients at final follow up, suggesting that anatomic reduction may not be mandatory. UPLOAD- https://planion-client-files.s3.amazonaws.com/AOSSM/blobs/2f636269-0d58-4854-8d4a-568086ef7844/1/AOSSM_Table_Yen.docx |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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