Background:Suture and screw fixations are widely used to treat tibial eminence fractures (TEFs). Although a few biomechanical and clinical studies have compared suture fixation (SF) and screw fixation in the treatment of TEFs in children, no comparative clinical studies are available regarding headless screw fixation (HSF).Purpose:To evaluate the clinical and functional outcomes of children with TEF who underwent SF and HSF.Study Design:Cohort study; Level of evidence, 3.Methods:The study included 24 patients treated with either SF (11 patients) or HSF (13 patients) within 1 month of TEF (type 2 or 3) without associated ligamentous and bone injury between 2015 and 2020. All patients were evaluated at a minimum 2-year follow-up in terms of Lysholm score, Tegner activity level, International Knee Documentation Committee subjective score, and isometric strength test. Knee stability was compared based on the Lachman test, pivot-shift test, and KT-1000 arthrometer side-to-side difference.Results:No significant differences were found between the 2 groups in terms of Lysholm score, Tegner activity level, and International Knee Documentation Committee subjective score at follow-up. All patients were able to resume their daily activities within 6 months after the injury. However, flexion deficits (6°-10°) were found in 2 patients in the SF group and 1 patient in the HSF group, and extension deficits (3°-5°) were found in 3 patients in the SF group and 1 patient in the HSF group, without significant intergroup difference. Stability based on the Lachman test, pivot-shift test, and KT-1000 arthrometer side-to-side difference was also similar between the 2 groups at follow-up. No statistically significant difference was found between the 2 groups in isometric tests performed.Conclusion:The present study is the first to compare the clinical and functional results of SF and HSF techniques. The HSF technique demonstrated comparable clinical and functional outcomes, suggesting its potential as an alternative to the SF technique.

中文翻译：

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缝合与无头螺钉固定治疗儿童胫骨隆起骨折的临床和功能结果

背景：缝合和螺钉固定广泛用于治疗胫骨隆起骨折（TEF）。尽管一些生物力学和临床研究比较了缝线固定（SF）和螺钉固定治疗儿童 TEF 的效果，但尚无关于无头螺钉固定（HSF）的临床比较研究。 目的：评估儿童的临床和功能结果与接受 SF 和 HSF 的 TEF 一起。研究设计：队列研究；证据级别，3。方法：该研究包括 2015 年至 2020 年间在 TEF（2 型或 3 型）1 个月内接受 SF（11 名患者）或 HSF（13 名患者）治疗且没有相关韧带和骨损伤的 24 名患者。患者在至少 2 年的随访中接受了 Lysholm 评分、Tegner 活动水平、国际膝关节文献委员会主观评分和等长力量测试方面的评估。基于Lachman测试、枢轴移位测试和KT-1000关节计左右差异比较膝关节稳定性。结果：两组之间在Lysholm评分、Tegner活动水平和国际水平方面没有发现显着差异膝关节记录委员会随访时的主观评分。所有患者均能在受伤后 6 个月内恢复日常活动。然而，SF 组 2 例患者和 HSF 组 1 例患者发现屈曲缺陷（6°-10°），SF 组 3 例患者和 1 例患者发现伸展缺陷（3°-5°）。在HSF组中，没有显着的组间差异。随访时，基于 Lachman 测试、枢轴移位测试和 KT-1000 关节计左右差异的稳定性也相似。两组之间进行的等长测试没有发现统计学上的显着差异。结论：本研究是第一个比较SF和HSF技术的临床和功能结果的研究。HSF 技术表现出可比的临床和功能结果，表明其作为 SF 技术替代方案的潜力。