The Incidence of Pediatric Tibial Spine Fractures Is Greater and Peaks Later in Male Patients.

Purpose: To use government-curated databases to produce incidence estimates for pediatric tibial spine fractures (TSFs) by age and sex. This study also describes the relative frequency of operative versus nonoperative management for TSFs by age and sex. Methods: US Healthcare Cost and Utilization Project databases were used to identify cases of TSF among patients aged 7 to 18 years in the year 2016. Patient-linked deidentified data from New York, Maryland, and Florida were gathered from state databases, and repeat visits by the same patient were collapsed into individual records. TSF incidence was then calculated, with U.S. census data used to determine the number of children at risk. The proportion of cases treated nonoperatively was determined based upon procedural codes. Results: In New York, Florida, and Maryland, 185 cases of TSF were found. Male patients accounted for 69.7% of cases. Incidence peaked at 9.3 per 100,000 at age 14 years for male patients and at 3.4 per 100,000 at age 9 years for female patients. In total, 57.9% of TSF cases were treated nonoperatively. The overall incidence of TSF was 2.8 cases per 100,000 for people aged 7 to 18 years. Conclusions: This study confirms a difference in incidence by sex for pediatric TSFs, with male patients having a greater peak incidence that also occurs at an older age. Most cases in this study were treated nonoperatively. Clinical Relevance: Due to the relative infrequency of TSFs in the pediatric population, there is a limited understanding of the epidemiology and treatment of these fractures. The use of data from a large patient database may provide valuable epidemiologic information about this uncommon injury.