ORIGINAL PAPER
Clinical patterns of knee fractures in children: a single-center case series
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Department of Orthopedics and Pediatric Orthopedics, Central Clinical Hospital in Lodz, Lodz, Poland
Submission date: 2025-10-22
Final revision date: 2026-04-19
Acceptance date: 2026-05-04
Online publication date: 2026-09-23
Publication date: 2026-10-07
Corresponding author
Weronika Kuźnik
Department of Orthopedics and Pediatric Orthopedics, Central Clinical Hospital in Lodz, Poland
Pediatr Pol 2026;101(3):252-256
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ABSTRACT
Introduction:
Fractures around the knee joint in pediatric patients are not the most common causes of hospitalization, but they should be considered. Most cases require invasive treatment to minimize adverse consequences of the injuries sustained. The aim of this study is to present the epidemiology of fractures in the knee joint area among pediatric patients who present to the Emergency Department due to knee joint injuries.
Material and methods:
Data were analyzed for all pediatric patients treated in the Emergency Department and subsequently hospitalized due to knee joint injuries in a tertiary referral hospital 2018–2023, according to codes S72.4, S82.0, S82.1, corresponding to fractures around the knee joint, including distal femoral, proximal tibial, and patellar fractures.
Results:
Among the qualified first-time patients, 23 were boys and 8 were girls. The largest portion of the group consisted of children aged 14–16 years. A predominance of patients with fractures of the proximal tibia was noted (27/31) compared to the distal femur (4/31). No patellar fractures were identified. Within the proximal tibia, the majority (12/27) suffered from an avulsion fracture of the anterior cruciate ligament (ACL), followed by tibial tubercle fractures (9/27), epiphyseal fractures (3/27), mixed tubercle and avulsion fractures of the ACL (2/27), and one fatigue fracture (1/27).
Conclusions:
In summary, the most common pediatric knee fractures are proximal tibial fractures, mainly ACL avulsion and tibial tubercle fractures. High-energy sports-related trauma are the leading cause, contributing to more severe fracture types. The findings align with global trends showing a rise in complex, sports-induced injuries in youth. This highlights the importance of prevention, early diagnosis, and proper treatment strategies.
REFERENCES (18)
3.
Stevens A, Patel N, Cruz A, Baghdadi S, Ellis H, Green D, et al. Poster 246: epidemiology of tibial spine fractures in children: a national multicenter study. Orthop J Sports Med 2023; 11: 2325967123S00226.
5.
Shin YW, Kim DW, Park KB. Tibial tubercle avulsion fracture according to different mechanisms of injury in adolescents: tibial tubercle avulsion fracture. Medicine (Baltimore) 2019; 98: e16700.
6.
Wang Y, Huang P, Fan M, Zhuang H, Guo R, Zheng P, et al. Risk factor analysis for tibial tubercle avulsion fractures in children. Int Orthop 2023; 47: 2347-2356.
8.
Sepúlveda M, Téllez C, Villablanca V, Birrer E. Distal femoral fractures in children. EFORT Open Rev 2022; 7: 264-273.
9.
Yoo MJ, Yoo JI, Lee JY, Park YJ, Kang-Heo. Treatment of typical trampoline fracture of the proximal tibia in children: results of minimum 1 year follow-up. Eur J Trauma Emerg Surg 2021; 47: 811-816.
10.
Mubarak SJ, Kim JR, Edmonds EW, Pring ME, Bastrom TP. Classification of proximal tibial fractures in children. J Child Orthop 2009; 3: 191-197.
11.
Meyers MH, McKeever FM. Fracture of the intercondylar eminence of the tibia. J Bone Joint Surg Am 1970; 52: 1677-1684.
12.
Baxter M, Wiley J. Fractures of the tibial spine in children. An evaluation of knee stability. J Bone Joint Surg Br 1988; 70-B: 228-230.
13.
LaValva SM, Aoyama JT, Adams AJ, Nako S. The epidemiology of tibial spine fractures in children: a multicenter investigation. Orthop J Sports Med 2020; 8: 2325967120S00172.
14.
Bauer T, Milet A, Odent T, Padovani JP, Glorion C. Fracture-avulsion de la tubérosité tibiale antérieure chez l’adolescent: à propos de 22 cas et revue de la littérature. Rev Chir Orthop Rép Appar Moteur 2005 ; 91: 758-767.
15.
Mosier SM, Stanitski CL. Acute tibial tubercle avulsion fractures. J Pediatr Orthop 2004; 24: 181-184.
16.
Zukotynski BK, Brown D, Hori K, Silva M. Ambulatory surgical management of most displaced tibial tubercle fractures in children is safe and efficient. J Child Orthop 2023; 17: 590-597.
17.
Pretell-Mazzini J, Kelly DM, Sawyer JR, Esteban EMA, Spence DD, Warner WC Jr, et al. Outcomes and complications of tibial tubercle fractures in pediatric patients: a systematic review of the literature. J Pediatr Orthop 2016; 36: 440-446.
18.
Cant DALW, Faergemann C. The incidence of physeal fractures in the lower limb and the frequency of premature physeal closure: a cohort study of 236 patients. Acta Orthop 2023; 94: 289-294.