Long-Term Follow-Up of Anterior Tibial Eminence Fractures

Clinical and radiological results of arthroscopically treated tibial spine fractures in childhood

“…Although a few studies have shown no difference in outcome of displaced tibial spine fractures treated conservatively versus surgically [2,4,17,23,24], many other authors advocate the surgical option so as to treat possible associated lesions, like meniscal tears or osteochondral injuries [12,13]. Moreover, they support the opinion that the surgical option facilitates a more satisfactory reduction of the fracture, thus avoiding the possible risk of a meniscal entrapment under the fractured tibial eminence or a possible healing of the fracture in a non-anatomical position, with the consequence of further instability or loss of extension of the knee [4,6,13,19].…”

“…Indeed, fractures of the tibial eminence in the developing years often lead to an anterior knee laxity, regardless of the type of treatment performed [1,2,7,[22][23][24].…”

Pediatric ACL injuries: evaluation and management

“…During arthroscopy, one can see the ACL taking up tension as the knee is brought into full extension. Cadaveric work has found the greatest ACL tension at 0°or at 45°of flexion [41]; therefore, many authors recommend immobilization with casts at 10°-20°of flexion [42][43][44]. However, when each ACL bundle is examined independently, the AM bundle seems to tighten at about 60°of flexion, and the PL bundle tightens with extension [45].…”

“…Fixation can be performed with sutures [77][78][79][80][81], (Fig. 5) metal screws [82][83][84][85], bioabsorbable nails [86], Kirschner wires [36,41,43,76], or suture anchors [87,88]. Several reports have found that screws can actually weaken the small fragment or cause comminution [78] and thus recommend suture fixation, which has demonstrated similar or improved strength profiles [89][90][91].…”

“…Many operative treatment options have been described for these fractures, including open [36,74] or arthroscopic [42,43] reduction and casting and open [36,75,76] or arthroscopic [77,78] reduction and fixation. Fixation can be performed with sutures [77][78][79][80][81], (Fig.…”