Satisfactory outcome following arthroscopic fixation of tibial intercondylar eminence fractures in children and adolescents using bioabsorbable nails

Kristinsson, Jens; Elsøe, Rasmus; Jensen, Hans Peter; Larsen, Peter

doi:10.1007/s00402-021-03860-w

Cited by 12 publications

(7 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Coyle et al described patients after tibial eminence fractures having almost 5 mm of anterior tibial translation [ 6 ]. Similar to current literature [ 3 , 18 , 19 , 33 ], good-to-excellent objective knee stability was reported in the present study. When assessing a.p.…”

Section: Discussionsupporting

confidence: 92%

“…Current literature covers several open and arthroscopic surgical approaches of internal reduction and fixation, mainly including screws or high-tensile suture devices with postoperative arthrofibrosis and secondary ACL deficiency requiring reconstruction being the most common complications [ 2 , 4 – 6 , 10 , 17 , 23 , 26 , 31 , 32 , 36 , 44 , 45 ]. Recently, satisfactory patient-reported and functional outcomes in the treatment of intercondylar eminence fractures in children and adolescents with bio-absorbable nails were reported [ 19 ]. Generally, good clinical and functional outcomes have been reported after arthroscopic reduction and internal fixation (ARIF) of tibial eminence avulsion fractures, however, these studies are often limited to their small sample size [ 3 , 5 , 6 , 10 , 11 , 17 , 18 , 30 , 31 , 33 , 36 , 44 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Reliable ligamentous stability and high return-to-sport rates after arthroscopic reduction and internal fixation of tibial eminence fractures

Lutz

Geyer

Winkler

et al. 2021

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

Purpose To investigate functional and clinical outcomes, and physical activity after arthroscopic suture fixation of tibial eminence fractures with regard to postoperative stability, range of motion (ROM), complications, and return to sports. Methods Patients undergoing arthroscopic reduction and internal fixation (ARIF) of tibial eminence fractures using a suture fixation technique were included. Outcome was evaluated retrospectively after a minimum follow-up of 24 months using KT-1000 arthrometer measurements, clinical examination, outcome scores (Lysholm score, Tegner Activity Scale), and a questionnaire about sport activities. Results A total of 23 patients (44% male, 57% female) with a mean age of 25 ± 15 years were included. Mean follow-up was 57 ± 25 months. KT-1000 arthrometer measurements of anterior tibial translation revealed a mean side-to-side difference of 0.9 ± 1.0 mm. Clinical examination showed 100% normal or nearly normal anterior translation of the tibia. Two patients (9%) received an ACL reconstruction due to traumatic ACL re-instability and were, therefore, considered as failures. An extension deficit concerning hyperextension occurred in 29% of patients postoperatively. Further postoperative complications occurred in 14% of patients and included postoperative stiffness with ROM limitations and secondary dislocation of a fragment. Mean postoperative Lysholm score was 89 ± 14. Comparing pre- and postoperative values, no significant change of the Tegner Activity Scale was observed. All patients (failures excluded) returned to high impact sports activities after ARIF. Conclusion Excellent reliable ligamentous stability and high rates of return to high impact sports can be expected after ARIF using a suture fixation technique for type II–IV tibial eminence fractures. Complications, such as limitations in ROM, commonly occur in up to 30% after ARIF. Therefore, regular follow-up examinations remain important in this usually young patient cohort. Level of Evidence Level IV.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Reliable ligamentous stability and high return-to-sport rates after arthroscopic reduction and internal fixation of tibial eminence fractures

Lutz

Geyer

Winkler

et al. 2021

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

show abstract

“…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 ].…”

Section: Resultsmentioning

confidence: 99%

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

Chandanani,

Jaibaji,

Jaibaji

et al. 2024

Children

View full text Add to dashboard Cite

Background: Tibial spine avulsion fractures (TSAFs) account for approximately 14% of anterior cruciate ligament injuries. This study aims to systematically review the current evidence for the operative management of paediatric TSAFs. Methods: A search was carried out across four databases: MEDLINE, Embase, Scopus, and Google Scholar. Studies discussing the outcomes of the surgical management of paediatric TSAFs since 2000 were included. Results: Of 38 studies included for review, 13 studies reported outcomes of TSAF patients undergoing screw fixation only, and 12 studies used suture fixation only. In total, 976 patients underwent arthroscopic reduction and internal fixation (ARIF), and 203 patients underwent open reduction and internal fixation (ORIF). The risk of arthrofibrosis with the use of ARIF (p = 0.45) and screws (p = 0.74) for TSAF repair was not significant. There was a significantly increased risk of knee instability (p < 0.0001), reoperation (p = 0.01), and post-operative pain (p = 0.007) with screw fixation compared to sutures. Conclusions: While the overall benefits of sutures over screws and ARIF over ORIF are unclear, there is clear preference for ARIF and suture fixation for TSAF repair in practice. We recommend large-scale comparative studies to delineate long-term outcomes for various TSAF fixation techniques.

show abstract

“…With the advancement of the times and the development of medical technology, arthroscopic technique is considered to be the gold standard for the treatment of tibial intercondylar ridge avulsion fractures. A variety of techniques, including metal screws [ 9 ], stainless steel wires [ 10 ], K-wires [ 11 ], suture anchors [ 12 , 13 ], sutures [ 14 ], bioabsorbable nails [ 15 ], and steel wires with suture disks [ 16 ], are advocated for treating such injuries. Each approach has its own advantages and disadvantages.…”

Section: Introductionmentioning

confidence: 99%

The most economical arthroscopic suture fixation for tibial intercondylar eminence avulsion fracture without any implant

Yuan¹,

Shi²,

Chen

et al. 2022

J Orthop Surg Res

View full text Add to dashboard Cite

Background Avulsion fracture of the tibial intercondylar eminence is a rare injury, which mainly occurs in adolescents aged 8–14 years and in those with immature bones. The current commonly used surgery may result in severe surgical trauma, affecting knee joint function and accompanied by serious complications. In this study, we described an all-inside and all-epiphyseal arthroscopic suture fixation technique for a patient to treat tibial intercondylar eminence fracture. Methods ETHIBOND EXCEL-coated braided polyester sutures were used for fixation. Three ETHIBOND sutures were passed through the ACL at 2, 6 and 10 o’clock of the footprint of the ACL and made a cinch-knot loop separately. Under the guidance of ACL tibial locator, three corresponding tibial tunnels were drilled with K-wires at 2, 6 and 10 o’clock of the fracture bed, and the two ends of the suture were pulled out through the tunnel with double-folded steel wire heads. After reduction of the tibial eminence, three sutures were tightened and tied to the medial aspect of the tibial tubercle. Results After all the surgical treatments surgically performed by this method and following a standard postoperative protocol, our patient's ROM, stability, and functional structural scores all improved significantly. Conclusion This three-point suture technique provides a suitable reduction and stable fixation and is suitable for patients with all types of avulsion fractures of the tibial intercondylar eminence.

show abstract

Satisfactory outcome following arthroscopic fixation of tibial intercondylar eminence fractures in children and adolescents using bioabsorbable nails

Cited by 12 publications

References 25 publications

Reliable ligamentous stability and high return-to-sport rates after arthroscopic reduction and internal fixation of tibial eminence fractures

Reliable ligamentous stability and high return-to-sport rates after arthroscopic reduction and internal fixation of tibial eminence fractures

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

The most economical arthroscopic suture fixation for tibial intercondylar eminence avulsion fracture without any implant

Contact Info

Product

Resources

About