CLINICAL OUTCOME OF ARTHROSCOPIC REDUCTION AND FIXATION BY PULL THROUGH SUTURE TECHNIQUE IN TIBIAL SPINE FRACTURES

Abstract

Background -Tibial spine avulsion fracture is bony avulsions of anterior cruciate Ligament (ACL) from its attachment on the anteromedial portion of the intercondylartibial eminence. If not treated well, Tibial spine fractures can lead to non-union or malunion, which can lead to signicant disability in the form of exion deformity,loss of extension, or instability. Aims And Objectives: This study was conducted with the aim of evaluating clinical outcome of arthroscopic reduction and xation of fractures by pull through suture technique and complications associated with the procedure. Thi Material And Method: s prospective with retrospective study analyzed 20 patients (16 males and 4 females), with mean age of 28.6 ± 9.8 years (range, 15-55). Patients were classied by Meyers and Mckeever type III (n=16) and IV (n=4) and were operated arthroscopically by pull through suture technique. They were followed over a mean period of 10±2.8 months. Postoperative assessment was done by using Lachman test, Lysholm knee score and international knee documentation Committee (IKDC) score. Objective assessment of anterior translation of tibia was done by using indigenously developed device named Laxometer. At the end of follow up,17 of 20 patient had no or minimal anterior transl Results: ation of tibia by Lachman test. The mean preoperative Lysholm score in 20 knees was 38 (range 29 to 55) and mean post-operative Lysholm score was 96 (range 83-100). At the end of follow up 17 of 20 (85%) patients accessed by IKDC score were normal/ nearly normal grade A/B and 3 patients were abnormal (grade C). All patients achieved union within 3 months (range 8 to 17 weeks). 20% patients had restricted range of motion. Arthroscopic pull Conclusion: through suture technique has good clinical outcomes in both type III and type IV fractures, and in all age groups (open and closed physis) with minimal complications. This was evidenced by no instability and residual ACL deciency, postoperatively at 1 year. Most patients have excellent recovery with full return of knee range of motion.