{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T04:23:46Z","timestamp":1787631826024,"version":"build-2736575974"},"reference-count":17,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T00:00:00Z","timestamp":1654041600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2022,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Type 1 tibial spine fractures are nondisplaced or \u22642 mm\u2013displaced fractures of the tibial eminence and anterior cruciate ligament (ACL) insertion that are traditionally managed nonoperatively with immobilization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Hypothesis:<\/jats:title>\n                    <jats:p>Type 1 fractures do not carry a significant risk of associated injuries and therefore do not require advanced imaging or additional interventions aside from immobilization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Case series; Level of evidence, 4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We reviewed 52 patients who were classified by their treating institution with type 1 tibial spine fractures. Patients aged \u226418 years with pretreatment plain radiographs and \u2264 1 year of follow-up were included. Pretreatment imaging was reviewed by 4 authors to assess classification agreement among the treating institutions. Patients were categorized into 2 groups to ensure that outcomes represented classic type 1 fracture patterns. Any patient with universal agreement among the 4 authors that the fracture did not appear consistent with a type 1 classification were assigned to the type 1+ (T1+) group; all other patients were assigned to the true type 1 (TT1) group. We evaluated the rates of pretreatment imaging, concomitant injuries, and need for operative interventions as well as treatment outcomes overall and for each group independently.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 48 patients met inclusion criteria; 40 were in the TT1 group, while 8 were in the T1+ group, indicating less than universal agreement in the classification of these fractures. Overall, 12 (25%) underwent surgical treatment, and 12 (25%) had concomitant injuries. Also, 8 patients required additional surgical management including ACL reconstruction (n = 4), lateral meniscal repair (n = 2), lateral meniscectomy (n = 1), freeing an incarcerated medial meniscus (n = 1), and medial meniscectomy (n = 1).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The classification of type 1 fractures can be challenging. Contrary to prior thought, a substantial number of patients with these fractures (&gt;20%) were found to have concomitant injuries. Overall, surgical management was performed in 25% of patients in our cohort.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259671221099572","type":"journal-article","created":{"date-parts":[[2022,6,3]],"date-time":"2022-06-03T14:06:18Z","timestamp":1654265178000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Is Nonoperative Treatment Appropriate for All Patients With Type 1 Tibial Spine Fractures? A Multicenter Study of the Tibial Spine Research Interest Group"],"prefix":"10.1177","volume":"10","author":[{"given":"Jilan L.","family":"Shimberg","sequence":"first","affiliation":[{"name":"Investigation performed at University Hospitals Rainbow Babies and Children\u2019s Hospital, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomasina M.","family":"Leska","sequence":"additional","affiliation":[{"name":"Investigation performed at University Hospitals Rainbow Babies and Children\u2019s Hospital, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Aristides I.","family":"Cruz","sequence":"additional","affiliation":[{"name":"Investigation performed at University Hospitals Rainbow Babies and Children\u2019s Hospital, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Henry B.","family":"Ellis","sequence":"additional","affiliation":[{"name":"Investigation performed at University Hospitals Rainbow Babies and Children\u2019s Hospital, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neeraj M.","family":"Patel","sequence":"additional","affiliation":[{"name":"Investigation performed at University Hospitals Rainbow Babies and Children\u2019s Hospital, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Meng","family":"Yen","sequence":"additional","affiliation":[{"name":"Investigation performed at University Hospitals Rainbow Babies and Children\u2019s Hospital, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Tibial Spine Research Interest Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory A.","family":"Schmale","sequence":"additional","affiliation":[{"name":"Investigation performed at University Hospitals Rainbow Babies and Children\u2019s Hospital, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Justin","family":"Mistovich","sequence":"additional","affiliation":[{"name":"Investigation performed at University Hospitals Rainbow Babies and Children\u2019s Hospital, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter D.","family":"Fabricant","sequence":"additional","affiliation":[{"name":"Investigation performed at University Hospitals Rainbow Babies and Children\u2019s Hospital, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore J.","family":"Ganley","sequence":"additional","affiliation":[{"name":"Investigation performed at University Hospitals Rainbow Babies and Children\u2019s Hospital, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel W.","family":"Green","sequence":"additional","affiliation":[{"name":"Investigation performed at University Hospitals Rainbow Babies and Children\u2019s Hospital, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Johnson","sequence":"additional","affiliation":[{"name":"Investigation performed at University Hospitals Rainbow Babies and Children\u2019s Hospital, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Indranil","family":"Kushare","sequence":"additional","affiliation":[{"name":"Investigation performed at University Hospitals Rainbow Babies and Children\u2019s Hospital, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Jay","family":"Lee","sequence":"additional","affiliation":[{"name":"Investigation performed at University Hospitals Rainbow Babies and Children\u2019s Hospital, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott D.","family":"McKay","sequence":"additional","affiliation":[{"name":"Investigation performed at University Hospitals Rainbow Babies and Children\u2019s Hospital, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd A.","family":"Milbrandt","sequence":"additional","affiliation":[{"name":"Investigation performed at University Hospitals Rainbow Babies and Children\u2019s Hospital, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Rhodes","sequence":"additional","affiliation":[{"name":"Investigation performed at University Hospitals Rainbow Babies and Children\u2019s Hospital, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brant","family":"Sachleben","sequence":"additional","affiliation":[{"name":"Investigation performed at University Hospitals Rainbow Babies and Children\u2019s Hospital, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica L.","family":"Traver","sequence":"additional","affiliation":[{"name":"Investigation performed at University Hospitals Rainbow Babies and Children\u2019s Hospital, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,6,3]]},"reference":[{"key":"bibr1-23259671221099572","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000001080"},{"key":"bibr2-23259671221099572","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520951192"},{"key":"bibr3-23259671221099572","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000001654"},{"key":"bibr4-23259671221099572","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-018-5039-7"},{"key":"bibr5-23259671221099572","doi-asserted-by":"publisher","DOI":"10.1016\/j.aaen.2004.03.007"},{"key":"bibr6-23259671221099572","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-200505000-00031"},{"key":"bibr7-23259671221099572","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.74B6.1447245"},{"key":"bibr8-23259671221099572","doi-asserted-by":"publisher","DOI":"10.1177\/03635465020300051201"},{"key":"bibr9-23259671221099572","volume":"2","author":"Kushare I","year":"2020","journal-title":"J Pediatr Orthop Surg North Am"},{"key":"bibr10-23259671221099572","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-201007000-00002"},{"key":"bibr11-23259671221099572","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-195941020-00002"},{"key":"bibr12-23259671221099572","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000000249"},{"key":"bibr13-23259671221099572","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000001110"},{"key":"bibr14-23259671221099572","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2017.11.013"},{"key":"bibr15-23259671221099572","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520957666"},{"key":"bibr16-23259671221099572","doi-asserted-by":"publisher","DOI":"10.1177\/2325967120975410"},{"key":"bibr17-23259671221099572","doi-asserted-by":"publisher","DOI":"10.1177\/036354659101900303"}],"container-title":["Orthopaedic Journal of Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259671221099572","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/23259671221099572","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23259671221099572","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:08:47Z","timestamp":1777594127000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/23259671221099572"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,1]]},"references-count":17,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,6,1]]}},"alternative-id":["10.1177\/23259671221099572"],"URL":"https:\/\/doi.org\/10.1177\/23259671221099572","relation":{},"ISSN":["2325-9671","2325-9671"],"issn-type":[{"value":"2325-9671","type":"print"},{"value":"2325-9671","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,1]]},"article-number":"23259671221099572"}}