Heldt B, Roepe I, Guo R, Attia E, Inneh I, Shenava V, Kushare I. All-epiphyseal versus trans-epiphyseal screw fixation for tillaux fractures: Does it matter? World J Orthop 2022; 13(2): 131-138 [PMID: 35317400 DOI: 10.5312/wjo.v13.i2.131]
Corresponding Author of This Article
Indranil Kushare, DNB, MBBS, Assistant Professor, Department of Orthopedic Surgery, Texas Children's Hospital, 17850 I-45 South, Houston, TX 77030, United States. ikushare@texaschildrens.org
Research Domain of This Article
Orthopedics
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Brett Heldt, Isaiah Roepe, Raymond Guo, Department of Orthopedic Surgery, Baylor College of Medicine, Houston, TX 77030, United States
Elsayed Attia, Ifeoma Inneh, Vinitha Shenava, Indranil Kushare, Department of Orthopedic Surgery, Texas Children's Hospital, Houston, TX 77030, United States
Author contributions: All the authors contributed appropriately and equally in the execution of the study and drafting of manuscript.
Institutional review board statement: This study was approved by IRB for retrospective review of pediatric patients with Tillaux fracture.
Conflict-of-interest statement: The authors report no conflict of interest.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at ikushare@texaschildrens.org.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Indranil Kushare, DNB, MBBS, Assistant Professor, Department of Orthopedic Surgery, Texas Children's Hospital, 17850 I-45 South, Houston, TX 77030, United States. ikushare@texaschildrens.org
Received: June 11, 2021 Peer-review started: June 11, 2021 First decision: July 28, 2021 Revised: August 5, 2021 Accepted: January 13, 2022 Article in press: January 13, 2022 Published online: February 18, 2022
ARTICLE HIGHLIGHTS
Research background
Operative management of Tillaux fractures in adolescent patients is recommended for more than 2 mm of displacement or more than 1 mm of translation with screw fixation.
Research motivation
The efficacy, superiority and complications of trans-physeal vs all-physeal screw fixation have not been investigated in literature yet.
Research objectives
To compare outcomes of trans-physeal and all-epiphyseal screw fixation in management of Tillaux fractures in young patients.
Research methods
The patients were divided into group 1 (oblique screw fixation) and group 2 (parallel screw fixation). Patient characteristics and functional outcomes were compared between groups.
Research results
A total of 42 patients (28 females and 14 males) were divided into Groups 1 and 2, which consisted of 17 and 25 patients, respectively. Statistical analysis revealed no significant differences in the functional outcomes, pain scores, or satisfaction between groups.
Research conclusions
In young patients with Tillaux fractures, comparing functional outcomes of different methods of screw fixation orientation to the physis, showed no difference regarding functional outcomes.
Research perspectives
Based on our findings, oblique screws, which provide better compression of the Tillaux fracture, are recommended over parallel screws, which create more joint forces and require a more difficult screw trajectory.
