Arthroscopic Suture Fixation of Tibial Eminence Avulsion Fractures

Huang, Tsan-Wen; Hsu, Kuo-Yao; Cheng, Chun‐Ying; Chen, Lih-Huei; Wang, Ching‐Jen; Chan, Yi‐Sheng; Chen, Wen-Jer

doi:10.1016/j.arthro.2008.07.008

Cited by 90 publications

(99 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It reduces complications and morbidity of patients. 6,18 In our study, common age of presentation in paediatric group (n=8) is 8-14 years and in adult group (n=44) is 20-51 years. With contrast to many studies, we found higher incidence among adults than children.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic treatment of displaced tibial eminence fractures using wire loop technique

et al. 2018

View full text Add to dashboard Cite

INTRODUCTIONTibial eminence fracture is a bony avulsion of the anterior cruciate ligament from its insertion on the anteromedial tibial eminence. 1 These injuries are commonly seen in children aged between 8-14 years and are usually sports related, however in adults these injuries are mainly related to high energy trauma usually road traffic accidents and concomitant injury to the menisci, articular cartilage, and collateral ligaments can also be seen. [2][3][4][5][6][7][8] Meyers and McKeever in 1959 described the severity of the displacement of fracture into 3 types, type I fractures have minimal or no displacement of the fragment, type II fractures have anterior one half avulsion of the eminence, but seated posterior part, and type III fractures have displaced fragment.9 Zaricznyj further modified and divided type III fractures into classes A and B, where type IIIA describes the pathology when the fragment with complete separation is displaced minimally, and type IIIB the pathology when the fragment is twisted or fragmented resulting in rotational malalignment. 10 ABSTRACTBackground: Several techniques of arthroscopic treatment of tibial spine avulsion fractures have been described in the literature. We conducted a study to analyze the results of arthroscopic assisted wire loop technique for treatment of tibial spine avulsion in adults and pediatric patients. Methods: From June 2011 to December 2016, 52 patients with tibial spine fractures were surgically treated with arthroscopic reduction and wire loop fixation. Forty-four patients were adults and eight were in their pediatric age group. The age group ranged from 9 years to 52 years with the mean age of 26.2 years. 28 patients were type 2 and 24 were of type 3 fracture as classified by Myeres and Mckeever's classification. The final analysis was done using clinical tests, radiological evaluation and International Knee Documentation Committee (IKDC) and Lysholm score. Results: At final follow-up, the mean IKDC and Lysholm knee scores were, 92 and 93 respectively. All patients had a complete functional recovery and were able to return to work and to resume their activities. Conclusions: Arthroscopic wire loop fixation is an excellent method for tibial eminence fracture in adults and children which gives excellent results in form of control tension on ACL on each side of avulsed fragment and also gives adequate mechanical strength for early rehabilitation.

show abstract

Section: Discussionmentioning

confidence: 99%

Arthroscopic treatment of displaced tibial eminence fractures using wire loop technique

et al. 2018

View full text Add to dashboard Cite

show abstract

“…5 This repair has been previously described using open and arthroscopic approaches, with the latter having a decreased risk of soft tissue complications and postoperative pain. 9,10 The avulsion fracture is repaired to the tibia using a variety of methods including the use of screws, button systems, anchors, and sutures.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Reduction of Tibial Spine Avulsion: Suture Lever Reduction Technique

Gamboa¹,

Durrant²,

Pathare³

et al. 2017

Arthroscopy Techniques

View full text Add to dashboard Cite

Tibial spine avulsion fractures are uncommon knee injuries that predominantly occur in children and young adults. Restoration of anterior cruciate ligament length through surgical reduction and fixation of the fracture is necessary to ensure stability of the knee with suitable range of motion and minimal knee laxity. Arthroscopic repair of tibial spine avulsion fractures is a technically complex procedure, specifically when performing and maintaining the initial anatomic reduction. We describe in this technical note and accompanying video a unique 3-point fixation repair of tibial spine avulsion fractures using an arthroscopic assisted suture lever reduction technique. Our technique is both simple and efficacious in the reduction of tibial spine avulsion fractures to anatomic position by passing the first suture through the anterior cruciate ligament, and subsequently anterior to the avulsion fragment, and then beneath the fragment through a posteriorly placed bone tunnel within the tibial fracture bed.

show abstract

“…Non operative treatment for type 2 to type 4 fractures, in form of manipulation in extension fails to achieve reduction of the fragment as the fracture lies in the intercondylar notch and not between the articulating surface of the tibia and femur. 2 Operative treatment is indicated for type 2, 3 and 4 fractures as these displaced fractures can develop nonunion or malunion resulting in knee instability and anterior impingement causing loss of knee extension 3 . Surgical techniques include open or arthroscopic reduction and internal fixation.…”

Section: Introductionmentioning

confidence: 99%

Arthroscopic fixation of anterior cruciate ligament tibial avulsion fractures: the suture “bridge” pull out technique and evaluation of results

et al. 2017

View full text Add to dashboard Cite

INTRODUCTIONTibial anterior cruciate ligament (ACL) avulsion fractures are a common injury in children and adolescents. In adults they account for 1% to 5% of ACL injuries.1 They are caused by a hyperextension injury of the knee or by a direct force over the distal femur with the knee in flexion. Meyers and McKeever have classified these injuries depending on the amount of displacement of the ACL tibial fragment as follows: type 1-minimal or undisplaced fracture fragment; type 2-elevation of only the anterior half of the fragment; type 3-complete displacement of the ABSTRACT Background: Tibial anterior cruciate ligament (ACL) avulsion fractures are a common injury in children and adolescents. Operative treatment is indicated for type 2, 3 and 4 fractures. Arthroscopic fixation is the preferred method and numerous fixation options are described. The purpose of this study is to evaluate the results of a new technique of arthroscopic fixation. Methods: A retrospective study was done involving twelve patients having displaced ACL tibial avulsion fractures. The arthroscopic suture "bridge" pull out technique was used to fix these fractures. Patient symptoms like knee pain, locking, clicking, sensation of giving way and clinical signs like tenderness, range of motion, Mc Murray's test, stability test and Lysholm knee scores were evaluated pre operatively and post operatively at 3 months and 6 months. Patient satisfaction was noted at latest follow up. Results: One patient had type 2, 7 patients had type 3 and 4 patients had type 4 tibial ACL avulsion fractures. All the fractures united and all patients achieved full knee range of motion by 2 months post-operative. The clinical symptoms and signs improved post operatively. The mean Lysholm knee score at 3 months follow up was 88.8 and at 6 months follow up were 98.8. At latest follow up, all the patients were satisfied with their knee function. Conclusions: The arthroscopic suture "bridge" pull out technique is an effective method for fixation of ACL tibial avulsion fractures with respect to knee stability, range of motion and resumption of pre injury activity level.

show abstract

Arthroscopic Suture Fixation of Tibial Eminence Avulsion Fractures

Cited by 90 publications

References 27 publications

Arthroscopic treatment of displaced tibial eminence fractures using wire loop technique

Arthroscopic treatment of displaced tibial eminence fractures using wire loop technique

Arthroscopic Reduction of Tibial Spine Avulsion: Suture Lever Reduction Technique

Arthroscopic fixation of anterior cruciate ligament tibial avulsion fractures: the suture “bridge” pull out technique and evaluation of results

Contact Info

Product

Resources

About