Poster 246: Epidemiology of Tibial Spine Fractures in Children: A National Multicenter Study

Objectives: Tibial spine fractures (TSFs) are avulsion at the insertion of anterior cruciate ligament tibial intercondylar eminence. TSFs rare injuries thought to occur most frequently in skeletally immature children aged 8 14 years. Historically, it was that common mechanism falling off bicycles, but recent research suggests a variety additional mechanisms. Treatment for can be operative or nonoperative depending on fracture type/severity, concomitant injuries, and surgeon patient/family preference. Estimates epidemiology this patient population limited primarily single-center reports. The objective investigation characterize epidemiology, including demographic information, injury mechanism, type, selection surgical nonsurgical treatment, across eight geographically distinct institutions using retrospective data. Methods: IRB reliance approval obtained each participating hospital. Patients younger than 25 years treated between January 1, 2000 31, 2019 were included. with multiple lower extremity other traumatic excluded. Data collected regarding demographics, mechanisms injury, imaging reports, injuries. presented as medians interquartile ranges. Categorical data counts percentages stratified by sex and/or Meyers McKeever type. Results: 661 patients met inclusion criteria. Median age presentation 12.2 (IQR 9.7-14.1), higher prevalence boys girls (66.1%, 437/661). Diagnosis study center occurred median 4.0 days 1.0-9.0 days) after injury. Of these patients, 71.6% (432/603) had first been seen elsewhere, commonly emergency department physicians (40.7%, 176/432). reported contact (44.4%, 244/549) twisting, non-contact (42.8%, 235/549), hyperextension representing much smaller proportion 3.6%. Injuries during sports 56.8% (355/625), which skiing (127/352, 36.1%) football (97/352, 27.6%). Distal femur proximal tibia growth plate status classified open 67.1% 72.6% cases, respectively. Both plates closed only 5.8% cases. type Type II (40.4%) III (44.4%). 83.3% (549/659) these, arthroscopically (ARIF) (470/549, 86.1%). Conclusions: This represents, our knowledge, largest epidemiological report date pediatric fractures. more males females (66.1% male), years, falls within range 8-14 Furthermore, regional physes, corroborating theory likely individuals. We believe useful towards counselling providing comprehensive view presentations treatment pathways population. [Table: see text] text][Table: