Is excessive body weight related to energy level of injury in tibial tubercle fractures in adolescents?

Abstract

To assess whether excessive body weight or obesity predisposes adolescents to tibial tubercle fractures from less energetic traumas, prolongs the period of rehabilitation from these injuries or leads to worse outcomes. A retrospective study of patients who underwent surgical treatment for fracture of the tibial tubercle in the period from March 2013 to March 2022. Patients were classified according to age, gender, fracture type, BMI, mechanism and energy levels of injury, time to complete painless range of motion was achieved and rate of complications. We have surgically treated 33 patients who have sustained 34 tibial tubercle fractures. Twenty of our patients had a BMI in the 'healthy weight' range while 13 were either overweight or obese. A significant difference in the distribution of injury types between the two groups has been statistically confirmed, whereby more severe injuries were recorded in the 'healthy weight' group of patients. A statistically significant higher proportion of patients who sustained a fracture after a blow to the knee or during light activity could have been confirmed in the 'overweight/obese' group while patients in the 'healthy weight' group more often sustained fractures after a powerful concentric or eccentric contraction of the quadriceps muscle. All of the patients achieved full painless range of motion and a radiologically confirmed osseous union. The healthy weight group had a significantly shorter period of rehabilitation. Two minor complications have been recorded. A higher BMI may lead to tibial tubercle fractures caused by less energetic injuries in adolescent patients. We may also conclude that blows to the knee or injuries sustained while running most often do not cause the most severe type of fractures. However, operative treatment provides a good outcome regardless of the type of injury or BMI.