All-epiphyseal headless screw fixation for Type III Paediatric Anterior Tibial Spine Fracture - A Case Report

Abstract

Background: Paediatric anterior tibial spine fractures are rare and the management is controversial. Type III and IV anterior tibial spine fractures need absolute reduction and fixation using arthroscopic or open methods. We present a case of a Type III anterior tibial spine fracture fixed with open reduction and internal fixation with headless compression screws. Case report: A 12-year female child involved in a sports injury sustained a Type III anterior tibial spine fracture. This was managed with open reduction and intraepiphyseal fixation with headless compression screws using medial parapatellar approach. Protected weight bearing and knee range of motion exercises were encouraged after surgery. Fracture healed well at 4 months and the child returned to normal functional activity. At one year follow-up, the child attained a stable knee with full range of motion without any complication. Conclusion: Open reduction and intraepiphyseal fixation with headless compression screws is a viable option for Type III anterior tibial spine fractures and avoids growth disturbances by preserving the physis.

Keywords

• Anterior tibial spine fractures
• ACL avulsion
• Headless compression screw
• Paediatric ACL