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Meniscal injuries in children and adolescents undergoing surgical treatment for tibial eminence fractures

  • Knee
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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To prospectively evaluate the prevalence and characteristics of meniscal injuries in children and adolescents undergoing surgical treatment for tibial eminence fractures and to test for possible relationships between associated meniscal lesions and patient demographics or injury characteristics.

Methods

A prospective multicenter study was conducted to arthroscopically assess the prevalence and characteristics of meniscal injuries in children and adolescents undergoing surgical treatment for tibial eminence fractures between 04/2014 and 10/2015. Patient demographics and injury characteristics were assessed preoperatively. The presence of a meniscal injury was evaluated arthroscopically and characterized according to tear type and location (Cooper classification). Patients with and without meniscal injuries were compared with regard to sex, age, height, weight, BMI, type of injury, mechanism of injury, time to surgery, Tanner stage, sexual maturity (prepubescent vs. pubescent), and modified Meyers and McKeever classification.

Results

A total of 54 consecutive patients (65 % males, mean age: 12.5 ± 3.2 years) were enrolled. Meniscal injury were found in 20 patients (37 %). The lateral meniscus was involved in 18 patients (90 % of all meniscus injuries) and the medial meniscus in 2 patients (10 % of all meniscus injuries). The most common tear pattern was a longitudinal tear of the posterior horn of the lateral meniscus (30 % of all meniscus injuries) and the second most common tear was a root detachment of the anterior horn of the lateral meniscus (20 % of all meniscus injuries). Higher age, advanced Tanner stage, and pubescence were significantly associated with an accompanying meniscal injury.

Conclusion

Meniscal injuries in children and adolescents undergoing surgical treatment for tibial eminence fractures must be expected in almost 40 %, with a higher prevalence with increasing age and sexual maturity. With regard to the clinical relevance, the results of the present study argue in favor for magnetic resonance imaging prior to surgery in every patient with a suspected tibial eminence fracture and for an arthroscopic approach to adequately diagnose and treat meniscal injuries.

Level of evidence

II.

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Authors and Affiliations

  1. Department of Orthopedic Surgery and Traumatology, Freiburg University Hospital, Hugstetter Straße 55, 79016, Freiburg, Germany

    Matthias J. Feucht, Hermann O. Mayr, Amelie Stoehr, Norbert P. Südkamp & Philipp Niemeyer

  2. Department for Orthopaedic Sports Medicine, Technische Universität München, Munich, Germany

    Peter U. Brucker & Stephan Lorenz

  3. Paediatric Orthopaedic Department, University Children’s Hospital Basle, Basle, Switzerland

    Carlo Camathias

  4. Department of Trauma and Reconstructive Surgery, Asklepios Clinic St. Georg, Hamburg, Germany

    Karl-Heinz Frosch

  5. Department of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland (Bruderholz, Liestal, Laufen), Basle, Switzerland

    Michael T. Hirschmann

  6. Department of Sports Traumatology, Knee- and Shoulder-Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt, Germany

    Philipp Minzlaff

  7. Department of Orthopaedic and Trauma Surgery, Martin Luther Hospital Berlin, Berlin, Germany

    Wolf Petersen

  8. Department of Reconstructive Joint Surgery, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Germany

    Tim Saier & Dorien Schneidmüller

  9. OCM-Clinic Munich, Munich, Germany

    Amelie Stoehr & Philipp Niemeyer

  10. Sportklinik Stuttgart GmbH, Stuttgart, Germany

    Daniel Wagner

Authors
  1. Matthias J. Feucht
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  2. Peter U. Brucker
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Correspondence to Matthias J. Feucht.

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Feucht, M.J., Brucker, P.U., Camathias, C. et al. Meniscal injuries in children and adolescents undergoing surgical treatment for tibial eminence fractures. Knee Surg Sports Traumatol Arthrosc 25, 445–453 (2017). https://doi.org/10.1007/s00167-016-4184-0

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  • DOI: https://doi.org/10.1007/s00167-016-4184-0

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