Adult tibial eminence fracture fixation: arthroscopic procedure using K-wire folded fixation

Abstract

The purpose of this article is to describe a new and simple technique for arthroscopic fixation of tibial intercondylar eminence avulsion fractures using folded surgical pin. This technique allows reduction and fixation of the bone fragment without using special equipment. After standard arthroscopic procedure to explore the knee and to remove fracture debris and blood clot, the bone block is reduced and advanced with the spike of the anterior cruciate ligament tibial drill guide. A 1.8-mm K-wire is drilled through the guide from the proximal tibia into the reduced fragment. It is bent on its end into the joint with a strong needle case. The K-wire is then pulled back until good fragment compression to the tibia appears with the wire starting unbending. Next, the other side is bent on the anterior tibial cortex and cut. This arthroscopic fixation allows elastic compression fragment stabilization that authorizes early weight bearing and rehabilitation programs. The material is extracted by traction after 6 months.

Anterior Cruciate Ligament Injury and Reconstruction

“…Regardless of the treatment method, residual laxity may be present after tibial eminence avulsion injuries. Arthroscopy and MRI for damage to other attached soft tissue structures allow for accurate reduction and treatment of these injuries [ 17 ]. Fixation can be achieved with sutures or hardware [ 17 -22 ].…”

Hybrid Fixation of Tibial Eminence Fractures in Skeletally Immature Patients

“…6 Several arthroscopic techniques have been reported in the literature that use various means for fixation such as metal screws, [12][13][14][15][16][17] staples, 18 K-wires 6,19 and sutures only, 18,[21][22][23][24][25]33 and anchors only. 28,29 Success in treating tibial eminence fractures is dependent on secure fixation, which can allow for early postoperative knee mobilization, decreased risk of arthrofibrosis, and a more rapid return to full activity.…”

“…For markedly displaced fractures, immediate anatomic reduction and fixation of the fragments are generally recommended to allow early return to range of motion and prevent arthrofibrosis. 10,11 Several arthroscopic techniques have been reported, such as metal screw fixation, [12][13][14][15][16][17] staple fixation, 18 K-wire fixation, 6,19,20 suture fixation, 18,[21][22][23][24][25][26][27] and anchor fixation. 28,29 However, a number of these techniques violate the growth plate, and in the case of metal screw fixation, retained hardware can result in the need to reoperate to remove hardware.…”

A new technique for arthroscopic reduction and fixation of displaced tibial intercondylar eminence fractures, using suture anchor and EndoButton system

“…1,[9][10][11] Several arthroscopic fixation techniques have been reported, such as crossed percutaneous pin fixation, 10 metal screws fixation, [12][13][14][15][16] staple fixation, 17 suture fixation, [18][19][20][21][22][23][24][25] and K-wire folded fixation. 26 Here, we describe a new technique using only one bone tunnel with suture anchor and EndoButton system, which is believed to be effective and may be another option for arthroscopic reduction and fixation of displaced tibial intercondylar eminence fractures. …”