FUNCTIONAL OUTCOME OF SCREW FIXATION IN MEYERS AND MCKEEVER TYPE 3 ANTERIOR TIBIAL SPINE FRACTURES

Abstract

Objective: To evaluate the short-term functional outcome of open reduction and internal screw fixation in patients with Meyers and McKeever type 3 anterior tibial spine fractures using the modified Lysholm knee scoring system. Study Design:

Prospective cohort study.

Place & Duration of Study: Conducted at the Orthopedic Unit of Ghurki Trust Teaching Hospital, Lahore, from December 01, 2024, to May 31, 2025. Methodology: A total of 60 patients aged 16 to 60 years with closed Meyers and McKeever type III anterior tibial spine fractures were enrolled in the study. The diagnosis was confirmed using 3D CT scans. All patients underwent open reduction and internal fixation with screws under spinal anesthesia, performed via a midline arthrotomy using a medial para-patellar approach. The functional outcome was evaluated two months post-operatively using the modified Lysholm score. Data were analyzed using SPSS version 20, with independent samples t-tests and one-way ANOVA applied for comparisons across gender, BMI, and age groups. A p-value ≤ 0.05 was considered statistically significant. Results: Of the 60 patients, 96.7% were male and 3.3% were female. The mean age was 26.58 ± 9.39 years, and the mean BMI was 23.54 ± 3.79 kg/m². The overall mean Lysholm score at two months post-operatively was 90.37 ± 9.99, indicating good functional recovery. No statistically significant differences were observed in Lysholm scores between genders (p = .204) or age groups (not tested with a single p-value). However, BMI groups did show a difference, although not statistically significant (p = .149), with patients having a normal BMI (≤ 25) showing slightly higher Lysholm scores than overweight patients (> 25).

Conclusion: Open reduction and internal screw fixation provide favorable short-term functional outcomes in Meyers and McKeever type 3 anterior tibial spine fractures. BMI was found to significantly influence recovery, while gender and age did not show a statistically significant impact.