An analysis of different types of surgical fixation for avulsion fractures of the anterior tibial spine.

This is a retrospective study of 25 patients, looking at the outcome of open reduction and fixation of displaced anterior tibial spine avulsion fractures with absorbable and non-absorbable materials. The mean period of follow-up was 44 months (range, 21 to 88 months). The results of surgery were assessed clinically and radiologically. Outcome was evaluated by using the Lysholm knee scoring system. Anterior cruciate ligament laxity was assessed by using a KT-1000 arthrometer and range of movements with a goniometer. Overall, children did better than adults, but age per se did not appear to affect the final outcome. There was no significant difference between children fixed with absorbable or non-absorbable materials. Adults fixed with non-absorbable material had significantly better results than those fixed with absorbable material. Herbert screws had a tendency to migrate into the bone substance, and are best avoided. Protected early mobilisation in a knee brace was found to be safe and helped to regain early range of movements in the knee joint.