Results of Anterior Cruciate Ligament Avulsion Fracture by Treatment Using Bioabsorbable Nails in Children and Adolescents

Abstract

(1) Background: Anterior cruciate ligament avulsion fractures are characteristic for skeletally immature patients, and appropriate treatment is currently debated in the literature. The study aimed to evaluate the clinical and functional outcomes in patients with tibial eminence fractures treated with bioabsorbable nails in one orthopedic clinic. (2) Methods: After retrospective evaluation, we found 17 patients with tibial eminence fractures treated in orthopedic departments between January 2013 and July 2022 using bioabsorbable fixation nails. The study group comprised 12 boys and five girls aged 5 to 15.2 (average 10.1). The mean follow-up was 28 months. We diagnosed five type II fractures, ten type III fractures, and two type IV fractures according to Meyers–McKeever classification. (3) Results: We obtained a high healing rate—17 patients with the complete union on the control radiographs. We diagnosed two cases of malunion, of which one required revision surgery. Only one patient showed a slight anterior knee laxity. The treatment effect at follow-up was assessed using the Lysholm Knee Score and IKDC Score. The median Lysholm Score was 96.64 (SD 4.54), and the median IKDC Score was 84.64 (SD 3.10), which were both excellent results. (4) Conclusions: Based on our results, surgery using bioabsorbable devices for type II, III, and IV tibial eminence fractures in young individuals is an effective alternative, allowing good outcomes and restoring proper knee stability. The crucial factor for a good effect is a stable fracture fixation. Arthroscopic surgery gives good outcomes with minimal invasion. It is important not to prolong the attempts of arthroscopic reduction and to perform the open reduction to shorten the procedure’s time and avoid complications.

Tibial Spine Avulsion Fractures in Paediatric Patients: A Systematic Review and Meta-Analysis of Surgical Management

“…A total of 21 cases used both screws and sutures. Thirteen studies reported outcomes with the use of screws only, of which ten studies used ARIF [ 18 , 21 , 24 , 25 , 26 , 29 , 30 , 36 , 39 , 42 ], one study used ORIF [ 33 ], and two studies used both ARIF and ORIF [ 43 , 47 ]. Twelve studies reported outcomes with the use of sutures only, of which nine studies used ARIF [ 11 , 13 , 16 , 31 , 32 , 37 , 45 , 46 , 48 ], and three studies used both ARIF and ORIF [ 17 , 19 , 38 ].…”

Arthroscopic fixation techniques for tibial eminence fractures in pediatric patients: a review

“…This injury commonly occurs during a fall from a bicycle or during a knee hyperextension with valgus external rotation maneuver during sports activities, and results in fractures of the intercondylar spine of the tibia that are not fully ossified. These injuries are most prevalent in boys aged 8–14 years old ( 2 – 4 ). In rare cases, TEFs may also occur as a result of direct trauma or hyperextension of the knee ( 5 ).…”