Fractures of the tibial spine: epidemiology and outcome.

We documented functional outcome in 83 knees with tibial spine fractures. The mean age at injury was 35 years. There was a medial collateral ligament sprain in 17 knees and posterolateral corner injury in three knees. Twenty patients with displaced tibial spine fractures were treated with fixation of the tibial spine and 63 patients with undisplaced or minimally displaced fractures were treated non-operatively. Fourteen (22%) non-operatively treated knees developed symptomatic instability, three of which underwent ACL reconstruction. Tibial spine fixation restored stability in 18 of 20 knees, but knee stiffness was more common in this group when compared to non-operatively treated knees (60% vs 19%, p<0.0005). Patients with postoperative knee stiffness had a mean age of 28 years compared to 18 in patients with no knee stiffness (p<0.05). We concluded that tibial spine fracture in skeletally mature patients is associated with a significant risk of knee stiffness and instability.