Abstract：
OBJECTIVE: There is growing interest in tibial tubercle fractures in pediatric and adolescent population within the last decade. However, there is limited evidence in the existing literature. Therefore, the purpose of this systematic review was to analyze and provide up-to-date data that may prove valuable in decision making and management of these injuries in the general as well as the athletic population.
METHODS: A systematic review of the literature in PubMed, Cochrane library and Virtual Health Library was conducted using the \"Preferred Reporting Items for Systematic Reviews and Meta-Analysis\" (PRISMA) guidelines. Articles published in English or Spanish, during the past 20 years, reporting outcomes of tibial tubercle fracture management in patients younger than 18 years old, with a mean follow-up of at least 6 months reporting outcomes, type of management and classification were included.
RESULTS: A total of 919 patients with 956 fractures in 25 retrospective cohort studies were included. The mean age was 14.4 ± 0.6 years while 766 [83%] were males and 740 [81%] of the injuries were sports-related. Associated injuries were reported in 91[10%] cases, most common being patellar tendon avulsion. Surgical management was chosen for 845[88%] of the cases, the vast majority being open reduction internal fixation (ORIF) with screws. Union was achieved in 954 [99.8%] cases. Complications and re-operations rate stood at 172[18%] and 161 [19% of the operations], respectively. Return to play (RTP) was reported in 11 [44%] of the studies standing at an average of 98.9% ± 3.6.
CONCLUSIONS: Essentially, this is an adolescent sports knee injury that needs careful planning before decision making because it may affect both RTP and joint preservation. Although union was achieved in almost all patients, there is a high risk of associated injuries, complications and reoperations. The surgeon should be confident to perform fracture fixation as well as addressing associated knee soft tissue injuries to achieve optimal outcomes.
METHODS: Level IV.
METHODS: A systematic review of the literature in PubMed, Cochrane library and Virtual Health Library was conducted using the \"Preferred Reporting Items for Systematic Reviews and Meta-Analysis\" (PRISMA) guidelines. Articles published in English or Spanish, during the past 20 years, reporting outcomes of tibial tubercle fracture management in patients younger than 18 years old, with a mean follow-up of at least 6 months reporting outcomes, type of management and classification were included.
RESULTS: A total of 919 patients with 956 fractures in 25 retrospective cohort studies were included. The mean age was 14.4 ± 0.6 years while 766 [83%] were males and 740 [81%] of the injuries were sports-related. Associated injuries were reported in 91[10%] cases, most common being patellar tendon avulsion. Surgical management was chosen for 845[88%] of the cases, the vast majority being open reduction internal fixation (ORIF) with screws. Union was achieved in 954 [99.8%] cases. Complications and re-operations rate stood at 172[18%] and 161 [19% of the operations], respectively. Return to play (RTP) was reported in 11 [44%] of the studies standing at an average of 98.9% ± 3.6.
CONCLUSIONS: Essentially, this is an adolescent sports knee injury that needs careful planning before decision making because it may affect both RTP and joint preservation. Although union was achieved in almost all patients, there is a high risk of associated injuries, complications and reoperations. The surgeon should be confident to perform fracture fixation as well as addressing associated knee soft tissue injuries to achieve optimal outcomes.
METHODS: Level IV.
摘要：
目的：在过去的十年中，儿童和青少年人群对胫骨结节骨折的兴趣与日俱增。然而,现有文献中的证据有限。因此,本系统综述的目的是分析和提供最新数据,这些数据可能证明对一般人群和运动人群的这些损伤的决策和管理有价值.
方法：对PubMed，Cochrane图书馆和虚拟健康图书馆使用“系统审查和荟萃分析的首选报告项目”（PRISMA）指南进行。用英语或西班牙语发表的文章，在过去的20年里，报告18岁以下患者的胫骨结节骨折治疗结果，平均随访至少6个月报告结果，包括管理类型和分类。
结果：共纳入了25项回顾性队列研究中的919例患者和956例骨折。平均年龄为14.4±0.6岁，而766[83％]为男性，740[81％]的伤害与运动有关。91例[10%]病例报告了相关伤害，最常见的是髌腱撕脱。845例[88%]的病例选择了手术治疗，绝大多数是用螺钉切开复位内固定(ORIF)。在954例[99.8％]中实现了联盟。并发症和再次手术率为172[18%]和161[19%]，分别。在11项[44％]的研究中报告了重返游戏（RTP），平均为98.9％±3.6。
结论：本质上，这是一种青少年运动性膝关节损伤,在做出决定之前需要仔细规划,因为它可能会影响RTP和关节的保存.尽管几乎所有患者都实现了联合，相关伤害的风险很高，并发症和再次手术。外科医生应该有信心进行骨折固定术以及解决相关的膝关节软组织损伤，以达到最佳效果。
方法：四级。
方法：对PubMed，Cochrane图书馆和虚拟健康图书馆使用“系统审查和荟萃分析的首选报告项目”（PRISMA）指南进行。用英语或西班牙语发表的文章，在过去的20年里，报告18岁以下患者的胫骨结节骨折治疗结果，平均随访至少6个月报告结果，包括管理类型和分类。
结果：共纳入了25项回顾性队列研究中的919例患者和956例骨折。平均年龄为14.4±0.6岁，而766[83％]为男性，740[81％]的伤害与运动有关。91例[10%]病例报告了相关伤害，最常见的是髌腱撕脱。845例[88%]的病例选择了手术治疗，绝大多数是用螺钉切开复位内固定(ORIF)。在954例[99.8％]中实现了联盟。并发症和再次手术率为172[18%]和161[19%]，分别。在11项[44％]的研究中报告了重返游戏（RTP），平均为98.9％±3.6。
结论：本质上，这是一种青少年运动性膝关节损伤,在做出决定之前需要仔细规划,因为它可能会影响RTP和关节的保存.尽管几乎所有患者都实现了联合，相关伤害的风险很高，并发症和再次手术。外科医生应该有信心进行骨折固定术以及解决相关的膝关节软组织损伤，以达到最佳效果。
方法：四级。
