Functional outcome in tibial spine fracture treated with arthroscopic pull through suture technique

Sapre, V. B.; Dwidmuthe, Samir; Bagaria, Vaibhav; Yadav, Sidharth

doi:10.4103/0975-7341.183956

J Orthop Traumatol Rehabil

2015

DOI: 10.4103/0975-7341.183956

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Functional outcome in tibial spine fracture treated with arthroscopic pull through suture technique

V. B. Sapre

Samir Dwidmuthe

Vaibhav Bagaria

et al.

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Cited by 12 publications

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“…In adults, the injury is typically a result of high-energy trauma and is more frequently associated with other concomitant injuries, such as a meniscal tear or collateral ligament injury, than in the pediatric population. 2,19 Pediatric patients who are skeletally immature have an open physis that may be violated or damaged during fixation attempts; however, it is unclear what role the open physis may play in the ultimate failure strength of surgical fixation constructs used for tibial eminence fractures.…”

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confidence: 99%

Effect of Skeletal Maturity on Fixation Techniques for Tibial Eminence Fractures

Thome

O’Donnell

DeFroda

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Several fixation methods have been reported for the operative treatment of tibial eminence fractures. Previous biomechanical studies have demonstrated that suture fixation may be a stronger construct; however, the maturity status of these specimens was not scrutinized. Purpose: To examine if suture fixation remains a biomechanically superior fixation method to screw fixation in both skeletally mature and immature specimens. Study Design: Controlled laboratory study. Methods: Sixteen total matched porcine (Yorkshire) knees (8 skeletally immature knees and 8 skeletally mature knees) were procured, and a standardized tibial eminence fracture was created. In each age-matched group of knees, 4 knees underwent randomization to fixation with 2 screws while 4 knees were randomized to fixation using a dual-suture technique. Once fixation was complete, the specimens underwent cyclic loading (200 cycles) in the anteroposterior plane of the tibia and load-to-failure testing, both with the knee positioned at 30° of flexion. Relevant measurements were recorded, and data were analyzed. Results: Among mature specimens, load to failure was 1.9 times higher in the suture fixation group compared with the screw fixation group (1318.84 ± 305.55 vs 711.66 ± 279.95 N, respectively; P = .03). The load to failure was not significantly different between the groups in immature specimens (suture: 470.00 ± 161.91 N vs screw: 348.79 ± 102.46; P = .08). Conclusion: These findings suggest that suture fixation may represent a better construct choice for fixation of tibial eminence fractures in the skeletally mature population. However, in the skeletally immature population, fixation with screws or suture may be equivalent. Displacement after cyclic loading did not appear to differ by fixation method, nor did stiffness. Clinical Relevance: A stronger fixation construct may be beneficial and allow for earlier range of motion to help potentially decrease postoperative stiffness. Clinical studies are warranted to see if these results may be replicated in humans.

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mentioning

confidence: 99%

Effect of Skeletal Maturity on Fixation Techniques for Tibial Eminence Fractures

Thome

O’Donnell

DeFroda

et al. 2021

Orthopaedic Journal of Sports Medicine

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Arthroscopic Reduction and Fixation of Tibial Spine Avulsion Fractures by a Stainless Steel Wiring Technique

Abdel-Hamid

Bayoumy

Elkady

et al. 2017

Arthroscopy Techniques

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Several techniques of arthroscopic treatment of tibial spine avulsion fractures have been described in the literature. These techniques include the use of various fixation devices such as screws, K-wires, wiring, sutures, and suture anchors. In this study, we evaluate a new wiring technique for the treatment of these injuries. This technique involves fixation by stainless steel tension wires passed over the fractured spine and tied over a bone bridge. The advantages of this technique are that it aids in reduction, allows for compression of the tibial spine fragment anatomically in its fracture bed, provides stable fixation in difficult comminuted fractures, and allows for early mobilization and weight bearing because of the solid fixation.

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Arthroscopic reduction of adult comminuted tibial eminence avulsion with single tunnel pull-through suture fixation: A case report of technical note

Nikmatullah

Hernugrahanto

2022

International Journal of Surgery Case Reports

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Functional outcome in tibial spine fracture treated with arthroscopic pull through suture technique

Cited by 12 publications

References 27 publications

Effect of Skeletal Maturity on Fixation Techniques for Tibial Eminence Fractures

Effect of Skeletal Maturity on Fixation Techniques for Tibial Eminence Fractures

Arthroscopic Reduction and Fixation of Tibial Spine Avulsion Fractures by a Stainless Steel Wiring Technique

Arthroscopic reduction of adult comminuted tibial eminence avulsion with single tunnel pull-through suture fixation: A case report of technical note

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