Cartilaginous tibial eminence fractures in children: which recommendations for management of this new entity?

Chotel, Franck; Raux, Sébastien; Accadbled, Franck; Gouron, Richard; Pfirrmann, Clémence; Bérard, J; Seil, Romain

doi:10.1007/s00167-015-3707-4

Cited by 29 publications

(14 citation statements)

References 32 publications

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“…Younger patients with a purely cartilaginous avulsion injury that may not be adequately visualized on CT can also benefit from MRI evaluation, 25 although these fractures are difficult to identify and can be missed. 26…”

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confidence: 99%

Tibial Spine Fractures in Children: Evaluation, Management, and Future Directions

et al. 2018

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Fractures of the tibial spine are estimated to occur in 3 per 100,000 children annually, but account for 2 to 5% of pediatric knee injuries with effusion. Although these fractures were historically associated with bicycle accidents, the surge of organized youth sports in recent decades has brought renewed attention to this injury. While minimally displaced fractures can be treated nonoperatively, several techniques have been described for fixation of displaced or comminuted fractures. Sequelae of this injury can include arthrofibrosis, knee instability, and nonunion. Future collaborative endeavors will aim to further identify risk factors for these complications to optimize the treatment of tibial spine fractures in children.

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confidence: 99%

Tibial Spine Fractures in Children: Evaluation, Management, and Future Directions

et al. 2018

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“…The mechanism often varies between children and adults. 8 Between the ages of 14 and 16, there is trans-formation of chondroepiphyseal junction which ossifies and fuses at the site of the ACL tibial insertion. Once this transformation occurs, the ACL typically lacks the tensile strength to avulse the skeletally mature tibial ACL attachment.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic pull-through suture for tibial eminence avulsion fracture: a case series

2020

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Fractures of the tibial eminence is commonly reported in adolescents and adults, due to traffic accident, sports injury, or any other mechanism. Case 1: a 12-year-old male complained knee pain after a traffic accident 2 months prior to visit. Case 2: a 31-year-old female complained knee pain which worsened with long-distance walking and sitting, after falling on her knees one month prior to visit. Case 3: a 27-year-old female complained a worsening knee pain after traffic accident 12 years ago. Although it has been extensively studied, controversies regarding the best fixation method still exist. Open technique was once popular, but some morbidity has been associated with this method. Therefore, a new approach using arthroscopic pull-through suture technique, albeit technically challenging, is currently being advocated as a treatment option for such fractures. The result in our series confirm that all of 3 patients have a good result based on international knee documentation committee (IKDC) scoring for evaluation the treatment, hence support the use of this novel technique for the patients with tibial eminence avulsion fracture.

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“…18 A wide variety of fixation methods have been used to fix the fracture fragment, which include screws, sutures, K-wires, and staples. 19 At present, arthroscopically assisted treatment is the most common method; however, there have been no reports till date on the usage of tension band wire fixation technique for ACL avulsion fracture.…”

Section: Discussionmentioning

confidence: 99%

Tension Band Wire Fixation Technique for Anterior Cruciate Ligament Tibial Avulsion Fracture: A New Fixation Technique

et al. 2018

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This study evaluated clinical results of tension band wire fixation technique in the arthroscopic treatment of anterior cruciate ligament (ACL) tibial avulsion fracture. This study included 148 cases of ACL tibial avulsion fracture treated using arthroscopic tension band wire fixation technique. Patients were followed up for 25 to 36 months with an average of 27 months and evaluated in accordance with the International Knee Documentation Committee (IKDC) and Lysholm knee scoring scale. Fractures were united within 3 months after surgery in all cases. During the last follow-up, the anterior drawer, Lachman, and pivot shift tests showed negative, except for eight patients who had a 1-degree positive anterior drawer test. KT-1000 knee stability test showed no anterior instability exceeding 2 mm in 132 patients and 4 mm in 8 patients. In accordance with the IKDC scale, the knees of 132 patients were graded normal, whereas 8 other patients were nearly normal. Lysholm scores before surgery and during the last follow-up were 72.4 ± 3.2 and 97.5 ± 2.2, respectively. Statistically significant differences were observed among the Lysholm scores ( < 0.05). The Tegner scores were 6.5 ± 0.9 before injury and 6.4 ± 0.7 at the last follow-up ( > 0.05). No statistically significant differences between the preinjury and postoperative activity level were observed. All patients were satisfied with the outcomes of operation. Arthroscopic treatment of ACL tibial avulsion fracture by using tension band wire fixation technique ensures fracture healing and restores the stability and function of the joint in most patients. The level of evidence for this study is III.

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Cartilaginous tibial eminence fractures in children: which recommendations for management of this new entity?

Abstract: Retrospective case series, Level IV.

Cited by 29 publications

References 32 publications

Tibial Spine Fractures in Children: Evaluation, Management, and Future Directions

Tibial Spine Fractures in Children: Evaluation, Management, and Future Directions

Arthroscopic pull-through suture for tibial eminence avulsion fracture: a case series

Tension Band Wire Fixation Technique for Anterior Cruciate Ligament Tibial Avulsion Fracture: A New Fixation Technique

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