{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T04:50:19Z","timestamp":1791867019098,"version":"4.3.4"},"reference-count":41,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,8,13]],"date-time":"2023-08-13T00:00:00Z","timestamp":1691884800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Tibial eminence fractures (TEF) of Meyers\u2013McKeever type II-III-IV usually require surgical management. No consensus in the literature has been achieved regarding the best treatment option. The aims of the present systematic review were (1) to analyze the current literature and describe the outcomes of surgical treatment for TEF; and (2) to compare the outcomes of different surgical options using arthroscopic reduction and internal fixation (ARIF) with sutures or screws and open reduction and internal fixation (ORIF). Methods: A search was carried out with Pubmed, Medline, and Cochrane. Key terms were used \u201ctibial\u201d AND \u201ceminence\u201d or \u201cspine\u201d or \u201cintercondylar\u201d AND \u201cpaediatric\u201d or \u201cchildren\u201d AND \u201cfracture\u201d or \u201cavulsion\u201d AND \u201ctreatment\u201d. Twelve articles met the inclusion criteria. Demographic data, clinical outcomes, and complication rates were evaluated for each study. Means\/standard deviation and sum\/percentage were used for continuous and categorical variables, respectively. Chi-square or t-student tests were applied. A p-value &lt; 0.05 was considered statistically significant. Results: ORIF showed superior clinical outcomes (Tegner (p &lt; 0.05) and Lysholm (p &lt; 0.001) scores) relative to ARIF and a lower incidence of arthrofibrosis (p &lt; 0.05) and implant removal (p &lt; 0.01). The Tegner, IKDC, and Lysholm scores showed statistically significant superior results following arthroscopic sutures compared to arthroscopic screws (p &lt; 0.001). The incidence of arthrofibrosis was higher after arthroscopic sutures (p &lt; 0.05), the implant removal was higher after screw fixation (p &lt; 0.001) Conclusions: Better clinical results with low complication rates were achieved with ORIF surgery rather than ARIF; arthroscopic suture fixation resulted in higher clinical results compared to arthroscopic screw fixation and reduced the incidence of postoperative complications.<\/jats:p>","DOI":"10.3390\/children10081379","type":"journal-article","created":{"date-parts":[[2023,8,14]],"date-time":"2023-08-14T10:20:14Z","timestamp":1692008414000},"page":"1379","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Management and Outcomes of Tibial Eminence Fractures in the Pediatric Population: A Systematic Review"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7400-7609","authenticated-orcid":false,"given":"Beatrice","family":"Limone","sequence":"first","affiliation":[{"name":"Department of Traumatology, Orthopaedic and Occupational Medicine, CTO Hospital, University of Study of Turin, 10124 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7634-5692","authenticated-orcid":false,"given":"Francesco","family":"Zambianchi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Azienda Ospedaliero Universitaria di Modena, University of Modena and Reggio-Emilia, 41121 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Cacciola","sequence":"additional","affiliation":[{"name":"Department of Traumatology, Orthopaedic and Occupational Medicine, CTO Hospital, University of Study of Turin, 10124 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Seracchioli","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Azienda Ospedaliero Universitaria di Modena, University of Modena and Reggio-Emilia, 41121 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Catani","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Azienda Ospedaliero Universitaria di Modena, University of Modena and Reggio-Emilia, 41121 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Tarallo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Azienda Ospedaliero Universitaria di Modena, University of Modena and Reggio-Emilia, 41121 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1097\/00003086-199006000-00008","article-title":"Tibial Spine Fractures in Children","volume":"255","author":"Wiley","year":"1990","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"23259671211027237","DOI":"10.1177\/23259671211027237","article-title":"Pediatric Tibial Spine Fractures: Exploring Case Burden by Age and Sex","volume":"9","author":"DeFrancesco","year":"2021","journal-title":"Orthop. J. Sports Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"E87","DOI":"10.1097\/BPO.0000000000001080","article-title":"Epidemiology of Anterior Tibial Spine Fractures in Young Patients: A Retrospective Cohort Study of 122 Cases","volume":"39","author":"Axibal","year":"2019","journal-title":"J. Pediatr. Orthop."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"209","DOI":"10.2106\/00004623-195941020-00002","article-title":"Fracture of the Intercondylar Eminence of the Tibia","volume":"41-A","author":"Meyers","year":"1959","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1007\/s00167-018-5039-7","article-title":"A New, MRI-Based Classification System for Tibial Spine Fractures Changes Clinical Treatment Recommendations When Compared to Myers and Mckeever","volume":"27","author":"Green","year":"2019","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/S0030-5898(03)00004-X","article-title":"Tibial Eminence Fractures","volume":"34","author":"Accousti","year":"2003","journal-title":"Orthop. Clin. N. Am."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1016\/j.csm.2022.05.006","article-title":"Tibial Spine Fractures in Young Athletes","volume":"41","author":"Cruz","year":"2022","journal-title":"Clin. Sports Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"b2700","DOI":"10.1136\/bmj.b2700","article-title":"The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Healthcare Interventions: Explanation and Elaboration","volume":"339","author":"Liberati","year":"2009","journal-title":"BMJ"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1177\/0363546508330149","article-title":"Lysholm Score and Tegner Activity Level in Individuals with Normal Knees","volume":"37","author":"Briggs","year":"2009","journal-title":"Am. J. Sports Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"S208","DOI":"10.1002\/acr.20632","article-title":"Measures of Knee Function: International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS), Knee Outcome Survey Activities of Daily Living Scale (KOS-ADL), Lysholm Knee Scoring Scale, Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Activity Rating Scale (ARS), and Tegner Activity Score (TAS)","volume":"63","author":"Collins","year":"2011","journal-title":"Arthritis Care Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1177\/230949900901700117","article-title":"Review Article: Validity of the KT-1000 Knee Ligament Arthrometer","volume":"17","author":"Arneja","year":"2009","journal-title":"J. Orthop. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1177\/036354658201000306","article-title":"Evaluation of Knee Ligament Surgery Results with Special Emphasis on Use of a Scoring Scale","volume":"10","author":"Lysholm","year":"1982","journal-title":"Am. J. Sports Med."},{"key":"ref_13","unstructured":"OCEBM Levels of Evidence Working Group (2023, May 19). Available online: http:\/\/www.Cebm.Net\/Index.Aspx?O=5653\u2014Cerca Con Google."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1046\/j.1445-2197.2003.02748.x","article-title":"Methodological Index for Non-Randomized Studies (Minors): Development and Validation of a New Instrument","volume":"73","author":"Slim","year":"2003","journal-title":"ANZ J. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"639270","DOI":"10.3389\/fsurg.2021.639270","article-title":"Arthroscopically Assisted Cannulated Screw Fixation for Treating Type III Tibial Intercondylar Eminence Fractures: A Short-Term Retrospective Controlled Study","volume":"8","author":"Zheng","year":"2021","journal-title":"Front. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1097\/BPO.0000000000000356","article-title":"Results of Displaced Pediatric Tibial Spine Fractures: A Comparison Between Open, Arthroscopic, and Closed Management","volume":"35","author":"Edmonds","year":"2015","journal-title":"J. Pediatr. Orthop."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1097\/BPO.0000000000000476","article-title":"Open versus Arthroscopic Reduction for Tibial Eminence Fracture Fixation in Children","volume":"36","author":"Watts","year":"2016","journal-title":"J. Pediatr. Orthop."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1007\/s00402-017-2770-3","article-title":"Arthroscopic Fixation of Pediatric Tibial Eminence Fractures Using Suture Anchors: A Mid-Term Follow-Up","volume":"137","author":"Xu","year":"2017","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1007\/s00264-018-3855-5","article-title":"Management of a Type Two Avulsion Fracture of the Tibial Intercondylar Eminence in Children: Arthroscopic Suture Fixation versus Conservative Immobilization","volume":"42","author":"Zhao","year":"2018","journal-title":"Int. Orthop."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2325967119881961","DOI":"10.1177\/2325967119881961","article-title":"Suture Versus Screw Fixation of Tibial Spine Fractures in Children and Adolescents: A Comparative Study","volume":"7","author":"Callanan","year":"2019","journal-title":"Orthop. J. Sports Med."},{"key":"ref_21","first-page":"571","article-title":"Mid-Term Outcomes of Arthroscopic Suture Fixation Technique in Tibial Spine Fractures in the Pediatric Population","volume":"27","author":"Emre","year":"2021","journal-title":"Ulus. Travma Acil Cerrahi Derg."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Russu, O.M., Pop, T.S., Ciorcila, E., Gergely, I., Zuh, S.G., Tr\u00e2mbi\u021ba\u0219, C., Borodi, P.G., Incze-Bartha, Z., Feier, A.M., and Georgeanu, V.A. (2021). Arthroscopic Repair in Tibial Spine Avulsion Fractures Using Polyethylene Terephthalate Suture: Good to Excellent Results in Pediatric Patients. J. Pers. Med., 11.","DOI":"10.3390\/jpm11050434"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"S675","DOI":"10.1016\/j.jcot.2020.01.015","article-title":"Pediatric Tibial Eminence Fracture Treatment: A Case Series Using a Bioabsorbable Screw","volume":"11","author":"Honeycutt","year":"2020","journal-title":"J. Clin. Orthop. Trauma."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"103270","DOI":"10.1016\/j.otsr.2022.103270","article-title":"Arthroscopic Suture-Fixation of Anterior Tibial Intercondylar Eminence Fractures by Retensioning of the ACL and Hollowing of the Tibial Footprint: Objective and Subjective Clinical Results in a Paediatric Population","volume":"108","author":"Chalopin","year":"2022","journal-title":"Orthop. Traumatol. Surg. Res."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Zhang, L., Zhang, L., Zheng, J., Ren, B., Kang, X., Zhang, X., and Dang, X. (2020). Arthroscopic Tri-Pulley Technology Reduction and Internal Fixation of Pediatric Tibial Eminence Fracture: A Retrospective Analysis. BMC Musculoskelet. Disord., 21.","DOI":"10.1186\/s12891-020-03421-z"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e1011","DOI":"10.1016\/j.asmr.2021.03.005","article-title":"Tibial Spine Repair in the Pediatric Population: Outcomes and Subsequent Injury Rates","volume":"3","author":"Quinlan","year":"2021","journal-title":"Arthrosc. Sports Med. Rehabil."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"78","DOI":"10.3109\/17453678709146348","article-title":"Epidemiology of Knee Injuries in Children","volume":"58","author":"Skak","year":"1987","journal-title":"Acta Orthop. Scand."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e639","DOI":"10.1016\/j.asmr.2021.12.005","article-title":"The Incidence of Pediatric Tibial Spine Fractures Is Greater and Peaks Later in Male Patients","volume":"4","author":"DeFrancesco","year":"2022","journal-title":"Arthrosc. Sports Med. Rehabil."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1007\/BF00449677","article-title":"Fractures of the Intercondylar Eminence in Children and Adolescents","volume":"107","author":"Oostvogel","year":"1988","journal-title":"Arch. Orthop. Trauma. Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1177\/145749691009900109","article-title":"Pediatric Tibial Eminence Fractures: Arthroscopic Treatment Using K-Wire","volume":"99","author":"Furlan","year":"2010","journal-title":"Scand. J. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1097\/00003086-198509000-00007","article-title":"Rating Systems in the Evaluation of Knee Ligament Injuries","volume":"198","author":"Tegner","year":"1985","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1097\/BPO.0000000000002049","article-title":"A Multicenter Comparison of Open versus Arthroscopic Fixation for Pediatric Tibial Spine Fractures","volume":"42","author":"Shimberg","year":"2022","journal-title":"J. Pediatr. Orthop."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1093\/bmb\/ldw018","article-title":"Arthroscopic Treatment of Tibial Eminence Fracture: A Systematic Review of Different Fixation Methods","volume":"118","author":"Osti","year":"2016","journal-title":"Br. Med. Bull."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"23259671231176991","DOI":"10.1177\/23259671231176991","article-title":"Long-Term Outcomes of Tibial Spine Avulsion Fractures after Open Reduction with Osteosuturing Versus Arthroscopic Screw Fixation: A Multicenter Comparative Study","volume":"11","author":"Turati","year":"2023","journal-title":"Orthop. J. Sports Med."},{"key":"ref_35","first-page":"141","article-title":"Arthroscopic Treatment of Avulsed Tibial Spine Fractures Using a Transosseous Sutures Technique","volume":"81","author":"Wagih","year":"2015","journal-title":"Acta Orthop. Belg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1177\/0363546509348001","article-title":"Arthrofibrosis after Surgical Fixation of Tibial Eminence Fractures in Children and Adolescents","volume":"38","author":"Ganley","year":"2010","journal-title":"Am. J. Sports Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1016\/j.arthro.2014.02.028","article-title":"Acute and Subacute Complications of Pediatric and Adolescent Knee Arthroscopy","volume":"30","author":"Ashraf","year":"2014","journal-title":"Arthroscopy"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e58","DOI":"10.3928\/01477447-20131219-18","article-title":"Prevention of Arthrofibrosis after Arthroscopic Screw Fixation of Tibial Spine Fracture in Children and Adolescents","volume":"37","author":"Parikh","year":"2014","journal-title":"Orthopedics"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1590\/S0102-36162010000500006","article-title":"Complications of the screw\/washer tibial fixation technique for knee ligament reconstruction","volume":"45","author":"Almeida","year":"2015","journal-title":"Rev. Bras. Ortop."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.jor.2022.10.006","article-title":"Clinical Outcome of Arthroscopic Suture versus Screw Fixation in Tibial Avulsion of the Anterior Cruciate Ligament in Skeletally Mature Patients","volume":"35","author":"Jain","year":"2022","journal-title":"J. Orthop."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1097\/MOP.0000000000000176","article-title":"The Tibial Eminence Fracture in Skeletally Immature Patients","volume":"27","author":"Shin","year":"2015","journal-title":"Curr. Opin. Pediatr."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/8\/1379\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:32:33Z","timestamp":1760128353000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/8\/1379"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,13]]},"references-count":41,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,8]]}},"alternative-id":["children10081379"],"URL":"https:\/\/doi.org\/10.3390\/children10081379","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,13]]}}}