Abstract

Background: This study presents the clinical results from 22 children who underwent minimally invasive arthroscopically assisted screw fixation for the treatment of intercondylar eminence fractures.Methods: We retrospectively analyzed the clinical data of 22 children (aged 7.5 to 13.5 years) with type III tibial intercondylar eminence fractures who were treated in our department from March 2007 to September 2019. According to the type of operation, the patients were divided into two groups: group A (n = 12) received arthroscopically assisted cannulated screw fixation, and group B (n = 10) received open reduction and cannulated screw internal fixation. Radiography scans, Lysholm scores, International Knee Documentation Committee (IKDC) 2,000 subjective scores, Tegner scores, range of motion (ROM) of the knee, the anterior drawer test (ADT), the Lachman test, and the pivot-shift test were used to evaluate the clinical efficacy.Results: All 22 children were evaluated over a 12 to 58 month follow-up period (mean: 27.5 months). At the final exam, group A was significantly superior to group B in Lysholm scores (93.33 ± 3.55 vs. 86.20 ± 4.52), IKDC scores (92.06 ± 3.55 vs. 86.07 ± 5.81), and Tegner scores (7.75 ± 0.87 vs. 6.40 ± 0.52) and presented shorter operative times (25.42 ± 3.97 vs. 35.00 ± 5.27). The differences were statistically significant (P < 0.05). All the incisions healed primarily. No complications, such as fracture fragment displacement, delayed epiphyseal growth, or knee joint dysfunction, were observed. The drawer test, Lachman test, and pivot-shift test were negative for all patients.Conclusions: Arthroscopically assisted cannulated screw fixation is effective and safe for the treatment of tibial intercondylar eminence fractures, providing excellent stability and quick recovery of joint function.

Highlights

  • Tibial intercondylar eminence fractures are rare intra-articular fractures that primarily occur in children between 8 and 14 years of age [1]

  • This study presents the clinical results from 22 children who underwent minimally invasive arthroscopically assisted screw fixation for the treatment of intercondylar eminence fractures

  • 13.5 years) with type III tibial intercondylar eminence fractures who were treated in our department from March 2007 to September 2019

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Summary

Introduction

Tibial intercondylar eminence fractures are rare intra-articular fractures that primarily occur in children between 8 and 14 years of age [1]. The incidence rate of such fractures is ∼3/100,000. Tibial intercondylar eminence fractures are located at the insertion of the anterior cruciate ligament (ACL) of the knee. Violent traction on the ACL is a common cause of tibial intercondylar eminence fractures in children [3]. The ACL is prone to damage because the epiphyseal plate where the ACL attaches cannot provide sufficient force against the traction force of the ligament itself. Anatomic reduction of the fracture should be performed because intercondylar fractures are intraarticular fractures. This study presents the clinical results from 22 children who underwent minimally invasive arthroscopically assisted screw fixation for the treatment of intercondylar eminence fractures.

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