Variation Exists Among Asia Pacific and American Surgeons in the Treatment of Pediatric Tibial Eminence Fractures.

Purpose: To compare operative and nonoperative management strategies, fixation preferences, postoperative immobilization protocols, and approaches to managing postoperative complications among Asia Pacific (APAC) and North American surgeons. Methods: An online survey was distributed to orthopaedic surgeons within the Pediatric Research in Sports Medicine APAC group between January 2023 and June 2024. The survey, which is a modified version of the Pediatric Orthopaedic Society of North America (POSNA) survey, assessed surgeon demographics, treatment strategies, risk factors for postoperative arthrofibrosis, and responses to clinical vignettes. Results: Fifty-six out of 127 APAC surgeons responded to the survey. Compared with POSNA surgeons, APAC respondents were more likely to perform arthroscopic reduction and transphyseal suture fixation for type II (89.3% vs 37.4%, Conclusions: Although there was a 5-year gap between surveys, APAC surgeons were more likely than POSNA surgeons to perform arthroscopic reduction and transphyseal suture fixation for type 2 tibial spine fracture, favored longer postoperative immobilization, more frequently identified time from injury to surgery as the primary risk factor for arthrofibrosis, and were more inclined to manage early postoperative range-of-motion restriction nonoperatively. Clinical Relevance: Understanding regional differences in the management of tibial spine fractures may help identify areas of consensus and variation, inform best-practice guidelines, and ultimately improve patient outcomes.