[Results of treatment of the intercondylar eminence of tibia in children].

Abstract

Fracture of the tibial eminence in children is a condition in which there is no widely accepted and approved therapeutic scheme. The greatest divergence of treatment options concerns type II according to Mayers and McKeever classification. Described therapeutic options range from cast immobilisation of the lower extremity without attempt of closed reduction to open reduction with internal fixation. Paper shows the results of treatment of tibial emienence fractures in children treated at our institution. Cohort of patients consists of 21 children at age 7 to 16 years of age (mean 12.2 years). There were three cases of type I, five cases of type II and thirteen cases of type III fracture according to Mayers and McKeever classification. Operatively 16 patients were treated with type II and III fracture, and the rest of them were treated nonoperatively. Open reduction and internal fixation was performed according to modified technique described in 1937 by H. Lee. The results were evaluated by X-ray, clinical examination of stability and range of motion of the affected knee and by subjective clinical outcome with use of modified Lysholm knee scale. All patients treated operatively presented very good and good clinical outcome. Nonoperatively treated patients was a small and no homogenous group. Results of treatment ranged from very good to poor. Worse outcomes were associated with additional injuries to the affected knee (poor result in patient with type II fracture) and qualification for the conservative treatment in patient with type III fracture.