Arthroscopic reduction and suture fixation of displaced tibial intercondylar eminence fractures in adults

Abstract

Arthroscopy-assisted screw fixation is more stable, and it allows early exercise. However, the fragment must be large enough to be fixed with a screw. Comminuted or small fragments present limitations for screw fixation techniques. We used the non-absorbable intraligmentous suture to pull down the fragment regardless of small size or comminuted status. The technique is simple and provided secure fixation without damage to the ACL insertion. A second operation is not required to remove the hardware.

Tibial intercondylar eminence fractures in adults

“…Fractures of the tibial intercondylar eminence are classified into three types by Meyers and Mckeever: type I, minimal or non-displaced; type II, partially displaced or hinged fracture; and type III, completely displaced. Zaricznyj adds a comminuted fracture as type IV [2,4]. Although tibial intercondylar eminence fractures are rare, many authors have reported different treatments and surgical repairs.…”

“…Most authors agree that conservative treatment is sufficient for non-displaced fractures. Displaced fractures are considered an indication for surgery [4]. This is because they may result in non-union, malunion or loss of knee extension [3,5,6].…”

“…Open reduction and internal fixation with suture or metal hardware are the former approaches. Now, arthroscopy is used to fix the tibial eminence fragment as a minimally open procedure [4]. The prognosis with proper treatment is good.…”

Tibial Spine Fractures: A Long-term Follow-up Study of Open Reduction and Internal Fixation

“…The minimally displaced fractures (type 1, and ,2 mm type 2) can be treated conservatively in a long leg cast approximately 10-20 degrees flexion for the anterior 9,10 and 40 degrees flexion for posterior fractures. 11 Type 2 fractures with severe displacement and all type 3 fractures require surgical fixation. Both open and arthroscopic treatments have been well documented in literature with good results described.…”

Physeal sparing arthroscopic fixation of displaced tibial eminence fractures: a new surgical technique

“…Besides several types of different screws [5,28,30,34], wires [26] and folded surgical steels [7] sutures [3,19,21,35] were used.…”