Clinical patterns of knee fractures in children: a single-center case series

Abstract

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. 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. 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). 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.