FRACTURES OF THE TIBIAL COLUMN (FCT), FRACTURES OF THE TIBIAL EMINENCE OR INTERCONDYLAR EMINENCE

Introduction: Tibial spine fractures (TSCF), also called tibial eminence or intercondylar eminence fractures, are defined as bony or chondral avulsions of the tibial plateau at the point of insertion of the anterior cruciate ligament (ACL). It is equivalent in etiology to ruptures of the medial substance of the ACL in adults. Depending on the classification of the fracture, conservative or surgical treatment may be chosen. Objective: to detail the current information related to tibial spine fractures, epidemiology, mechanism of action, classification, treatment and complications. Methodology: a total of 38 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 27 bibliographies were used because the other articles were not relevant for this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: fractures of the tibial spine, bone avulsions, fractures of the tibial eminence, fractures of the intercondylar eminence. Results: the incidence of TSF in children and adolescents is increasing, being more prevalent in boys and in ages between 8 and 14 years. Non-surgical treatments are recommended for undisplaced or minimally displaced fractures, while more severe fractures, such as type III fractures, generally require surgical intervention. Surgical fixation with cannulated screws and sutures has proven to be effective, with good clinical and radiological results, especially in large or comminuted bone fragments. However, there are complications associated with both non-surgical and surgical treatment, with arthrofibrosis being the most common in surgical treatment. Early mobilization is crucial to avoid stiffness, and monitoring the position of the fragment with periodic radiographs is essential to ensure successful treatment. Conclusions: Pediatric tibial spine fractures (TSF), although infrequent, are on the increase due to increased sports activity in children and adolescents, especially in boys aged 8 to 14 years. The mechanisms of injury are similar to those in adults, but incomplete ossification of the tibial plateau facilitates avulsion fractures in children. These are classified according to displacement and complexity, and MRI is key to their diagnosis and treatment. Early treatment is crucial to prevent complications, and arthroscopic surgery is preferred for its lesser impact on soft tissues and faster recovery. KEYWORDS: Fractures, Tibial Spine, Avulsions, Tibial Eminence, Intercondylar Eminence.