The TightRope® fixation shows significantly lower initial displacement compared to the suture group. The TightRope® fixation might be an alternative for the repair of ACL tibial avulsion fractures that can be used arthroscopically.

The treatment of distal femoral fractures was for a long-time associated with high complication rates. Although implants and surgical techniques were improved, plate osteosynthesis and intramedullary nailing suffered from considerable rates of infection, non-union und malalignment. Attention to the soft tissue envelope by "biological" osteosynthesis and minimally invasive approaches resulted in decreased complication rates. Out of this movement grew the concept of minimal invasive plating with an internal fixator -- the LISS-DF (Less Invasive Stabilization System -- Distal Femur) -- and the retrograde nailing concept. This article should give a review about these two new techniques for the treatment of distal femoral fractures. Indications, the clinical use and the aftercare will be discussed.