Table 2.
A univariate analysis comparing surgical techniques for tibial tuberosity avulsion fractures type 4 modified Watson–Jones treated operatively. DCF: Distal Cortical Fixation; PST: Proximal Screw Technique; Crossed/other: Crossed pins or screws or screws inserted in multiple directions. * Although not all fluoroscopy studies proved a bi-cortical fixation, most operative reports stated that the posterior cortex was purchased. This discrepancy might originate from the round shape of the tibia and screws that were not directed in an exact anterior-to-posterior direction. The researchers used the fluoroscopy images for the current table formation and analysis.
| Variable | DCF (n = 21, 56.75%) | PST (n = 8, 21.62%) | Crossed/Other (n = 8, 21.62%) | Total (n = 37, 100%) | p Value |
|---|---|---|---|---|---|
| Materials and Methods | |||||
| Sex (Male) | 18 (85.7%) | 8 (100%) | 8 (100%) | 34 (91.9%) | 0.395 |
| Age (Years) | 14.88 ± 1.35 | 14.28 ± 1.11 | 15.28 ± 0.88 | 14.83 ± 1.23 | 0.263 |
| Side (Left) | 16 (76.2%) | 5 (62.5%) | 2 (25%) | 23 (62.2%) | 0.059 |
| Ethnicity | 0.644 | ||||
| Black | 9 (42.9%) | 4 (50%) | 5 (62.5%) | 18 (48.6%) | |
| White | 9 (42.9%) | 2 (25%) | 3 (37.5%) | 14 (37.8%) | |
| Hispanic/Asian/other | 3 (14.3%) | 2 (25%) | 0 (0%) | 5 (13.5%) | |
| Weight (kg) | 78.73 ± 20.35 | 75.42 ± 17.63 | 74.43 ± 19.42 | 77.09 ± 19.17 | 0.888 |
| Weight percentile | 84.34 ± 19.96 | 95.76 ± 4.79 | 76.26 ± 24.9 | 84.77 ± 19.91 | 0.14 |
| Time from presentation to surgery | 1.57 ± 2.29 | 2.75 ± 3.41 | 1.13 ± 0.354 | 1.73 ± 2.29 | 0.679 |
| Number of patients who underwent additional imaging studies | 0.004 | ||||
| CT | 1 (4.8%) | 3 (37.5%) | 4 (50%) | 8 (21.6%) | |
| MRI | 0 (0%) | 1 (12.5%) | 0 (0%) | 1 (2.7%) | |
| Duration of surgery (minutes) | 80.05 ± 26.13 | 68.88 ± 28.59 | 57.25 ± 11.89 | 72.5 ± 25.59 | 0.102 |
| Closed reduction (vs. open reduction) | 10 (47.6%) | 4 (50%) | 6 (75%) | 20 (54.1%) | 0.45 |
| Number of screws per surgery * | 0.014 | ||||
| 1 | 2 (9.5%) | 1 (12.5%) | 0 (0%) | 3 (8.1%) | |
| 2 | 14 (66.7%) | 5 (62.5%) | 1 (12.5%) | 20 (54.1%) | |
| 3 | 5 (23.8%) | 2 (25%) | 3 (37.5%) | 10 (27%) | |
| 4 | 0 (0%) | 0 (0%) | 1 (12.5%) | 1 (2.7%) | |
| K wires | 0 (0%) | 0 (0%) | 3 (37.5%) | 3 (8.1%) | |
| Screw size | 0.006 | ||||
| 4.0 | 3 (14.3%) | 0 (0%) | 0 (0%) | ||
| 4.5 | 15 (71.4%) | 5 (62.5%) | 1 (12.5%) | ||
| 6.5 | 2 (9.5%) | 2 (25%) | 2 (25%) | ||
| Mixed | 1 (4.8%) | 1 (12.5%) | 2 (25%) | ||
| K wires | 0 (0%) | 0 (0%) | 3 (37.5%) | ||
| Washer (yes) | 12 (57.1%) | 4 (50%) | 1 (12.5%) | 17 (45.9%) | 0.115 |
| Biocortical purchase | 13 (61.9%) * | 8 (100%) | 8 (100%) | 29 (78.4%) | 0.021 |
| Fasciotomy | 0.814 | ||||
| Surgical | 2 (9.5%) | 2 (25%) | 0 (0%) | 4 (10.8%) | |
| Traumatic (documented) | 5 (23.8%) | 1 (12.5%) | 1 (12.5%) | 7 (18.9%) | |
| Both | 1 (4.8%) | 0 (0%) | 0 (0%) | 1 (2.7%) | |
| Follow-up duration (weeks) | 35.17 ± 36.79 | 30.03 ± 20.84 | 28 ± 19.58 | 32.51 ± 30.34 | 0.883 |
| Duration of complete immobilization at full extension (weeks) | 4.7 ± 1.22 | 5.25 ± 1.75 | 4.56 ± 1.63 | 4.79 ± 1.42 | 0.707 |
| Duration of non-weight-bearing restriction (weeks) | 4.29 ± 1.98 | 5 ± 1.77 | 3.75 ± 1.98 | 4.32 ± 1.93 | 0.435 |
| Referral to physical therapy | 21 (100%) | 8 (100%) | 7 (87.5%) | 36 (97.3%) | 0.432 |
| Results | |||||
| Documented pain after 3 months | 0.517 | ||||
| Yes | 4 (19%) | 2 (25%) | 0 (0%) | 6 (16.2%) | |
| No | 13 (61.9%) | 6 (75%) | 7 (87.5%) | 26 (70.3%) | |
| Lacking sufficient follow-up | 4 (19%) | 0 (0%) | 1 (12.5%) | 5 (13.5%) | |
| Wound complications | 0 (0%) | 1 (4.8%) | 1 (12.5%) | 2 (5.4%) | 0.685 |
| Full range of motion on last follow-up | 0.761 | ||||
| Yes | 15 (71.4%) | 7 (87.5%) | 6 (75%) | 28 (75.7%) | |
| No | 3 (14.3%) | 0 (0%) | 0 (0%) | 3 (8.1%) | |
| Lacking sufficient follow-up | 3 (14.3%) | 1 (12.5) | 2 (25%) | 6 (16.2%) | |