SCREW VS. SUTURE FIXATION FOR TIBIAL EMINENCE FRACTURES: A META-ANALYSIS.

OBJECTIVES

To compare functional and surgical outcomes between screw and suture fixation in pediatric tibial spine fractures.

MATERIALS AND

METHODS

This systematic review followed PRISMA guidelines and was registered in PROSPERO (CRD420251022233). Cohort studies comparing arthroscopic screw versus suture fixation were included. The primary outcome assessed was postoperative knee function.

RESULTS

Four retrospective cohort studies were included, totaling 186 patients. No significant differences were found in knee function (SMD = -0.07; p = 0.702). Operative time was significantly shorter in the screw group (MD = -9.17 minutes; p < 0.001). However, this group showed a significantly higher risk of reoperation (RR = 1.78; p = 0.040) and implant removal (RR = 6.25; p = 0.040). No differences were observed regarding joint instability (RR = 0.90; p = 0.770) or return to sport (RR = 1.83; p = 0.190). Funnel plot analysis suggested potential publication bias.

CONCLUSION

Both techniques yielded similar postoperative functional outcomes. Screw fixation was associated with shorter operative time but higher complication rates. Level of evidence IIa; systematic review of cohort studies.