Combined apophyseal and epiphyseal fixation of Ogden type IIIA/IV tibial tubercle avulsion fractures provides favorable stability compared to isolated apophyseal screw fixation - a biomechanical study
Augmented apophyseal screw fixation of apoepiphyseal tibial tubercle avulsion fractures provides greater biomechanical stability than isolated apophyseal screw fixation. Regardless of fixation technique, Ogden type IV fractures are more unstable than Ogden type IIIA fractures, so an individualized treatment strategy based on fracture morphology is crucial. In case of an Ogden type IIIA or Ogden type IV fracture, surgeons should consider adding epiphyseal screws or a medial plate osteosynthesis to apophyseal screw fixation to best neutralize forces of the extensor mechanism, as long as the often compromised soft tissue envelope can tolerate greater surgical invasiveness.
Authors
- Boyko Gueorguiev (ORCID: https://orcid.org/0000-0001-9795-115X)
- Elmar Herbst (ORCID: https://orcid.org/0000-0002-5652-0692)
- Ivan Zderic (ORCID: https://orcid.org/0000-0003-0484-887X)
- Michael J. Raschke (ORCID: https://orcid.org/0000-0002-0265-8098)
- Christian Peez (ORCID: https://orcid.org/0000-0001-8055-289X)
- Ludmil Drenchev (ORCID: https://orcid.org/0000-0003-3543-0636)
- Hristo Skulev (ORCID: https://orcid.org/0000-0001-6696-7546)
- R. Geoff Richards (ORCID: https://orcid.org/0000-0002-7778-2480)
- Christoph Kittl (ORCID: https://orcid.org/0000-0002-8507-5735)
Institutions
- AO Foundation (CH)
- Bulgarian Academy of Sciences (BG)
- University Hospital Münster (DE)
- Institute of Metal Science, Equipment and Technologies (BG)
Publication Details
- Journal
- European Journal of Trauma and Emergency Surgery
- Published
- 2025-03-18
- DOI
- https://doi.org/10.1007/s00068-025-02814-w
- Citations
- 1
- Primary Topic
- Bone fractures and treatments
- Type
- article
- Field-Weighted Citation Impact
- 1.35