Epidemiology and management of proximal tibia fractures in children and adolescents: a population-based study based on the Kids’ Fracture Tool

Authors

  • Sini-Tuuli Koivisto University of Helsinki, Faculty of Medicine; Finnish Pediatric Orthopaedics Research Group (FIPO), Finland
  • Topi Laaksonen Department of Pediatric Orthopaedics and Traumatology, University of Helsinki and Helsinki New Children’s Hospital, Helsinki; Finnish Pediatric Orthopaedics Research Group (FIPO), Finland https://orcid.org/0000-0002-3925-2446
  • Juho-Antti Ahola Department of Pediatric Orthopaedics and Traumatology, University of Helsinki and Helsinki New Children’s Hospital, Helsinki; Finnish Pediatric Orthopaedics Research Group (FIPO), Finland
  • Ilkka Helenius Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki; Finnish Pediatric Orthopaedics Research Group (FIPO), Finland https://orcid.org/0000-0001-5200-3279
  • Antti Stenroos Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki; Finnish Pediatric Orthopaedics Research Group (FIPO), Finland https://orcid.org/0000-0003-4394-2826

DOI:

https://doi.org/10.2340/17453674.2022.4879

Abstract

Background and purpose: Proximal tibial fractures are infrequent injuries in children, and the literature on epidemiology, associated injuries, and management is limited. We calculated a population-based incidence and described the characteristics of proximal tibial fractures in children in terms of complications and management.
Patients and methods: This is a retrospective study over a 6-year-period during including 241 children with proximal tibial fractures who presented to our university hospital. Demographic and fracture-related data was collected from the Kids’ Fracture Tool. The number of children during the study period was collected from statistical yearbooks of the City of Helsinki to estimate annual incidence.
Results: Extra-articular fractures (129/241) peaked at the age of 3 and tibial tubercle (42/241) and intra-articular fractures (70/241) peaked at the age of 15. Annual incidences were estimated to be 3.4/100,000 children and 22/100,000 children in the age group of 13–16 years for ACL avulsions, and 3.8/100,000 children and 21/100,000 children in the age group of 13–16 years for tibial tubercle fractures. The incidence of vascular compromise (0%) and compartment syndrome was low (0.4 %, 1/241).
Conclusion: Proximal tibial fractures present with a bimodal distribution, with extra-articular fractures peaking at the age of 3 years and fractures of the tibial tuberosity and intra-articular fractures peaking at the age of 15 years. Additionally, associated compartment syndrome and vascular compromise was not as common as previously reported.

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Published

2022-10-20

How to Cite

Koivisto, S.-T., Laaksonen, T., Ahola, J.-A., Helenius, I., & Stenroos, A. (2022). Epidemiology and management of proximal tibia fractures in children and adolescents: a population-based study based on the Kids’ Fracture Tool. Acta Orthopaedica, 93, 826–830. https://doi.org/10.2340/17453674.2022.4879

Issue

Section

Non-randomized clinical study