Arthroscopic Fixation of Tibial Spine Avulsion in Skeletally Immature Patients by Double Tunnel Pull-out Suture Technique

Abstract

ABSTRACT Background: Tibial spine fracture is frequently seen by arthroscopic surgeons in pediatric population. The incompletely ossified tibial spine which is bio-mechanically weaker than the native highly elastic ACL fibers leads to this injury. Different fixation methods for tibial spine avulsion were illustrated in literature but worry remains about passing through the tibial physis. The most common fixation methods reported in this age are screws and pullout sutures. Aim of the study: is to evaluate the efficiency of arthroscopic tibial spine fixation by double tunnel pull-out suture technique in skeletally immature patients. Subjects and methods: From September 2019 to March 2020, an intervention clinical study was carried out at Al Azhar University Hospital and Alexandria Sporting Hospital, A number of 10 adolescent patients had avulsion tibial spine fracture classified Meyers & McKeever Type II and III were involved in our study. Results: the results revealed that there is major improvement of Lysholm score postoperatively and post operatively there is important improvement of mean anterior tibial translation. Conclusion: Arthroscopic fixation by Double Tunnel Pull-out Suture technique for tibial spine avulsion is a simple technique which offers secure fixation and reasonable clinical outcomes.