SCREW VS. SUTURE FIXATION FOR TIBIAL EMINENCE FRACTURES: A META-ANALYSIS

Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine

ABSTRACT Objectives: To compare functional and surgical outcomes between screw and suture fixation in pediatric tibial spine fractures. Materials and Methods: This systematic review followed PRISMA guidelines and was registered in PROSPERO (CRD420251022233). Cohort studies comparing arthroscopic screw versus suture fixation were included. The primary outcome assessed was postoperative knee function. Results: Four retrospective cohort studies were included, totaling 186 patients. No significant differences were found in knee function (SMD = −0.07; p = 0.702). Operative time was significantly shorter in the screw group (MD = −9.17 minutes; p < 0.001). However, this group showed a significantly higher risk of reoperation (RR = 1.78; p = 0.040) and implant removal (RR = 6.25; p = 0.040). No differences were observed regarding joint instability (RR = 0.90; p = 0.770) or return to sport (RR = 1.83; p = 0.190). Funnel plot analysis suggested potential publication bias. Conclusion: Both techniques yielded similar postoperative functional outcomes. Screw fixation was associated with shorter operative time but higher complication rates.