LONG-TERM FOLLOW-UP OF ANTERIOR TIBIAL SPINE FRACTURES IN CHILDREN

In a long-term follow-up (mean 16 years) of 61 children with anterior tibial spine fractures, subjective knee function (Lysholm score) was e xcellent or good in 87% of the subjects and fair in 13%. Eleven percen t of the children had a lower activity level (Tegner score) than desir ed. Muscle performance was affected in those subjects with the lowest Lysholm scores. Pathological knee laxity was found in 38% of the subje cts, but was not reflected in poor subjective knee function. Age at in jury did not influence the outcome. There was no indication that young children can eliminate slackness of the anterior cruciate ligament by further growth. Only in type III fractures was there a correlation be tween fracture displacement after healing and knee laxity, as well as between knee laxity and Lysholm score. Arthroscopy-guided or open redu ction and internal fixation seems to be a worthwhile procedure only in dislocated type III fractures.