BACKGROUND Tibial tubercle fractures (TTFs) are uncommon injuries, comprising <3% of all proximal tibial fractures. These fractures occasionally occur in conjunction with a patellar tendon injury (PTI). We aimed to identify risk factors associated with combined TTF and PTI. METHODS A retrospective review was performed of patients presenting to a single, tertiary children's hospital with TTF between 2012 and 2023. Demographic data, operative details, radiographs, and injury patterns were analyzed. Radiographs were assessed for the epiphyseal union stage (EUS), Ogden classification, and fracture patterns. Multiple logistic regression models were used to assess the impact of body mass index, comminution, fracture fragment rotation, EUS, bilateral injury, and Ogden classification on injury type. RESULTS We identified 262 fractures in 252 patients (mean age, 13.9 ± 1.31 years). Of the patients, 6% were female and 48% were Black. Of the 262 fractures, 228 (87%) were isolated TTFs and 34 (13%) were TTFs with PTI. Multivariable analysis demonstrated fragment rotation on lateral radiographs (p < 0.0001) and Ogden Type-I classification (p < 0.0001) to be the most predictive risk factors for a combined injury. Rotation was associated with a substantial increase in the odds of a combined injury, with an odds ratio of 22.1 (95% confidence interval [CI], 6.1 to 80.1). Ogden Type-I fracture was another significant risk factor, with an odds ratio of 10.2 (95% CI, 3.4 to 30.4). CONCLUSIONS The Ogden classification and fragment rotation are the most useful features for distinguishing between isolated TTF and combined TTF with PTI. This is the first study to identify risk factors for TTF combined with PTI. Surgeons may use this information to aid in preoperative planning. LEVEL OF EVIDENCE Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.

中文翻译：

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矢状碎片旋转和 Ogden I 型分类是胫骨结节骨折和髌腱联合损伤的标志。


背景 胫骨结节骨折 (TTF) 是一种罕见的损伤，占所有胫骨近端骨折的 <3%。这些骨折偶尔会与髌腱损伤 (PTI) 一起发生。我们的目的是确定与 TTF 和 PTI 联合相关的风险因素。方法 对 2012 年至 2023 年间在一家三级儿童医院就诊的 TTF 患者进行回顾性分析。分析了人口统计数据、手术细节、X 光片和损伤模式。通过 X 光片评估骨骺愈合阶段 (EUS)、Ogden 分类和骨折模式。使用多元逻辑回归模型评估体重指数、粉碎、骨折碎片旋转、EUS、双侧损伤和 Ogden 分类对损伤类型的影响。结果 我们在 252 名患者中发现了 262 处骨折（平均年龄，13.9 ± 1.31 岁）。在患者中，6% 是女性，48% 是黑人。在 262 例骨折中，228 例（87%）为孤立性 TTF，34 例（13%）为伴有 PTI 的 TTF。多变量分析表明，侧位X光片上的碎片旋转（p < 0.0001）和Ogden I型分类（p < 0.0001）是复合损伤最具预测性的危险因素。旋转与合并损伤的几率大幅增加相关，其几率为 22.1（95% 置信区间 [CI]，6.1 至 80.1）。 Ogden I 型骨折是另一个重要的危险因素，优势比为 10.2（95% CI，3.4 至 30.4）。结论 Ogden 分类和片段旋转是区分孤立 TTF 和组合 TTF 与 PTI 的最有用特征。这是第一项确定 TTF 与 PTI 结合的危险因素的研究。外科医生可以利用这些信息来帮助制定术前计划。 证据级别 诊断级别 III。有关证据级别的完整描述，请参阅作者须知。