36 cases of avulsion fracture of so-called "tibial spine" were reviewed. Authors proposed a new classification by modifying the previously proposed classifications (Meyers and Mckeever ; type I., II, IIIa, b: Zaricznyi ; type IIIc-comminuted;
Zifko
and
Gaudernak, type A.B), and a treatment protocol is also proposed; Type, IA, IB, Type IIA, IIB, Type IIIAa, IIIBa, IIIAb, IIIBb, IIIAc, IIIBc.
1. Type A (small fragment) fracture was more common in adults, while type B (large fragment) was more common in children and adolescents.
2. Non-comminuted large fragment involving the eminence could be successfully treated regardless of extent of displacement by closed reduction and cast immobilization.
3. All displaced type A fractures, comminuted fractures, fractures associating positive Lachman test with soft end-point, and any fracture associating the ligament injury in the same knee should be surgically treated.
4. In the surgically treated group, the results were equally good regardless of the severity of the initial injuries. If we can accurately differentiate the type A from type B, and if treatment regimen is correctly applied, the results will be
same
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