A hospital-based prospective study comparing nonoperative and operative treatment of type 2 tibial spine fractures
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20262911Keywords:
Arthrofibrosis knee stability, Nonoperative treatment, Operative treatment, Tibial spine fracture, Type 2 tibial spine fractureAbstract
Background: Type 2 tibial spine fractures present a therapeutic dilemma because both nonoperative and operative treatment are commonly used, with no universal consensus regarding the optimal approach.
Methods: This prospective hospital-based study included 60 patients with Type 2 tibial spine fractures treated at SMS Medical College, Jaipur, from August 2023 to July 2024. Thirty patients underwent operative fixation and 30 received nonoperative management. Outcomes assessed included complications, knee stability, range of motion, and subsequent surgical interventions.
Results: The operative group demonstrated significantly better knee flexion (132.40±5.29 degrees vs 124.33±6.58 degrees, p<0.001) and total arc of motion (132.53±5.36 degrees vs 124.07±6.53 degrees, p<0.001). Positive Lachman test was more frequent after nonoperative treatment (20.0% vs 6.7%). Arthrofibrosis occurred only in the operative group, whereas new ACL injury and re-fracture were observed only in the nonoperative group. Subsequent surgery was required in 6.7% of patients in each group.
Conclusions: Operative treatment was associated with better postoperative range of motion and less residual laxity, while nonoperative treatment showed more instability-related complications. Treatment should be individualized according to patient profile and injury characteristics.
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