Tibial Eminence Fractures Research Articles

Arthroscopic Suture Fixation of Tibial Eminence Fracture

Background: Tibial eminence fractures account for up to 5% of knee injuries with an effusion in the pediatric population. Displaced fractures require reduction and operative fixation via arthroscopic or open techniques. Indications: Arthroscopic suture fixation and screw fixation are 2 of the most commonly described techniques for tibial eminence fracture treatment. We describe our preferred technique of arthroscopic suture fixation given the versatility of this technique and decreased risks of hardware irritation or impingement, need for reoperation, and minimal risk of physeal damage. Technique Description: The arthroscopic suture fixation technique uses a standard anteromedial and anterolateral portal. After the fracture bed and hematoma are debrided and any interposing structures (ie, meniscus) are removed from the fracture site, 2 nonabsorbable sutures are passed through the substance of the anterior cruciate ligament (ACL). Using an ACL guide, 2 separate transtibial tunnels are drilled with a bone bridge in between—one at the anterolateral aspect of the fracture base and one at the anteromedial aspect. One limb from each suture is pulled out from each of the bone tunnels. The fragment is then reduced, and the sutures are tensioned and fixated using knotless suture anchors. Results: Overall prognosis following tibial eminence fracture fixation is favorable with more than 80% of patients returning to prior level of activity. Arthrofibrosis may occur in up to 25% of patients. Although some residual laxity may remain, there is a high return to sport and no difference in rate of subsequent ACL injury or surgery compared with a match cohort of pediatric ACL reconstructions. Discussion: Arthroscopic suture fixation of displaced tibial eminence fractures is a reliable technique with high return to sport and low risk of reoperation. Arthrofibrosis is common; thus, early, controlled knee range of motion following surgery is critical.

Bilateral Tibial Tubercle Fracture in Adolescence: A Case Report and Review of the Literature

Bilateral Tibial Tubercle Fracture in Adolescence: A Case Report and Review of the Literature

Fracture of the tibial tubercle does not affect clinical outcomes in medial opening wedge high tibial osteotomy with distal tibial tubercle osteotomy.

To investigate whether tibial tubercle fracture affected clinical outcomes and bony union in medial opening wedge high tibial osteotomy with distal tibial tubercle osteotomy (DTO) and to determine the anatomical risk factors for tibial tubercle fracture. All patients who underwent DTO were retrospectively reviewed, and 104 successive patients were included. The Knee Society Score and complications including tibial tubercle fracture were recorded. On radiographs and computed tomography scans, the length, thickness, width, height, and bony union of the osteotomized tibial tubercle and the posterior tibial slope were statistically analysed. Fracture of the tibial tubercle occurred intraoperatively in 11 patients (10.6%) and in the postoperative period in 1 (1.0%). The case of postoperative fracture showed non-union. There was no significant difference in the Knee Society Score between the non-fracture and fracture groups. There were significant differences in the posterior tibial slope and the height of the tibial tubercle between the groups (p < 0.0001 for each comparison). The logistic regression analysis showed that the height of the tibial tubercle was associated with a higher risk of the fracture of the tibial tubercle (p < 0.01; OR, 1.548; 95% CI, 1.149-2.085). However, there were no significant differences in the bony union rate of the tibial tubercle at 6months after surgery between the groups. Tibial tubercle fracture did not affect the clinical outcome and bony union in spite of the relatively high occurrence rate. Anatomical risk factors for the fractures was a lower tibial tubercle position. Level IV.

Surgical Fixation of Quadrimalleolar Fractures of the Ankle.

We present a technique of fixation of trimalleolar fractures with additional fracture of the anterior tibial tubercle ("quadrimalleolar") or anterior fibular rim ("quadrimalleolar equivalent"). Twenty-four patients with a mean age of 60 years were treated with open reduction and internal fixation of all 4 malleoli. There were 17 quadrimalleolar and 6 quadrimalleolar equivalent fractures. One patient had both anterior tibial and fibular avulsion fracture in addition to a trimalleolar ankle fracture. Surgical approaches and internal fixation were tailored individually. Twenty patients were operated in the prone position with direct fixation of the posterior malleolus and 4 patients in the supine position with anterior to posterior screw fixation of the posterior malleolus. After fixation of al 4 malleoli, only 1 patient (4%) required a syndesmotic screw for residual syndesmotic instability on intraoperative testing. There were no infections and no wound healing problems. All patients went on to solid union. Nineteen patients (79%) were followed for a mean of 77 months (range, 15-156 months). The Foot Function Index averaged 15 (range, 50 to 0), the Olerud and Molander Score averaged 79 (range, 45-100), and the American Orthopaedic Foot and Ankle Society Ankle and Hindfoot Scale averaged 87 (range, 39-100). Fixation of the anterior and posterior tibial fragments increases syndesmotic stability by providing a bone-to-bone fixation. Anatomic reduction of the anterior and posterior tibial rim restores the physiological shape of the tibial incisura and therefore facilitates fibular reduction.

Closed reduction in the treatment of tibial tubercle fractures.

Open reduction and internal fixation (ORIF) is considered the standard care for displaced tibial tubercle fractures, but closed reduction and internal fixation (CRIF) can also be successful. Our aim was to compare outcomes between ORIF and CRIF for tibial tubercle fractures. Children younger than 18 years presenting for a tibial tubercle fracture at a single institution. The main outcomes were operative details (blood loss, tourniquet time, operative time) and complications. Follow-up of at least one month was required. 98 fractures from 95 patients were included. Follow-up averaged 8.7 months. 49% of the fractures had intraarticular involvement (type III). The most common associated injuries were patellar tendon tears and compartment syndrome, occurring in 10.2% and 3.1% of patients, respectively. No meniscal or ligamentous injuries were encountered. ORIF was performed for 81 fractures and CRIF for 17. Both groups were similar regarding sex, age, weight, and follow-up duration (P>0.4). No tourniquet was used for CRIF, while the majority of ORIF cases utilized a tourniquet for an average of 50.6 minutes. Operative blood loss was 31mL less in CRIF (P<0.0001), and the procedure of CRIF was 23.3 minutes shorter than ORIF (P=0.0003). All cases, except 1 fracture treated with ORIF, achieved union. The complication rate was similar in both groups (P=0.79). At final follow-up, patients from both groups had favorable outcomes, with normal knee range of motion and angulation, gait, and quadriceps strength on exam. CRIF is often overlooked in the surgical treatment of displaced tibial tubercle fractures. It is a less invasive treatment option for such fractures and has advantages such as less bleeding, avoiding a tourniquet, and shorter operative duration. Patients treated with either ORIF and CRIF healed with similar rates of complications and had a satisfactory outcome. Given the rarity of associated meniscal or ligamentous injuries, open reduction to visualize the joint surface might not be needed for most patients. The two most common associated injuries, patellar tendon tears and compartment syndrome, can be preliminarily diagnosed pre-operatively. Closed reduction could be initially attempted for tibial tubercle fractures, even ones with intraarticular extension.

Arthroscopic treatment of tibial eminence fractures using double-loop endobutton device: Surgical technique and short-term treatment outcomes.

Objectives This study aims to explain the arthroscopic surgical technique of double-loop endobutton device for tibial eminence fractures and share the outcomes of this treatment method.Patients and methods Thirteen patients (10 males, 3 females; mean age 19.9±5.6 years; range, 14 to 34 years) with tibial eminence fractures type II, IIIa, and IIIb were analyzed retrospectively between March 2017 and March 2019. Knee laxity, Tegner Lysholm knee scores, the International Knee Documentation Committee (IKDC) scores, knee mobility, Lachman test, and bone union were analyzed after the arthroscopic fracture fixation with double-loop endobutton device at first and sixth months after surgery.Results First month mean IKDC scores were 38.0±7.0 and mean Tegner Lysholm scores were 50.3±5.8. Sixth month mean IKDC scores were 80.2±4.0 and mean Tegner Lysholm scores were 87.1±5.4. All patients showed negative Lachman test and negative pivot-shift test at final follow-up. Radiological bone union without reduction loss was also seen in all patients.ConclusionUsing double-loop endobutton device provides successful results to fix tibial eminence fractures.

Arthroscopic treatment of adult displaced tibial eminence fractures with anchor and pushlock fixation

Arthroscopic techniques are considered the gold standard for treatment of displaced avulsion fractures of the anterior cruciate ligament. However, most arthroscopic surgical techniques and fixation methods are technically demanding and require removal of hard implant. This report describes a new, easy, safe, and all-arthroscopic method for reduction and fixation of displaced tibial intercondylar eminence fractures by using 1 anchor and 1 Pushlock.From January 2015 to June 2017, 8 adult patients with type II and III displaced tibial intercondylar eminence fractures were operated using this technique. Clinical assessment included patient demographics, cause of injury, delay before surgery, operation time, time to return to work and sport, International Knee Documentation Committee scores, and Lysholm knee scores.The average operation time was 48 minutes. The average follow-up period was 12.5 months. At the 6-month follow-up, all patients had acquired fracture union and complete functional recovery and were able to return to work. International Knee Documentation Committee objective scores and Lysholm knee scores were 92.4 (range 88–94) and 93.6 (range 90–96), respectively. At the last follow-up, anterior drawer, Lachman's test, and pivot shift tests were negative, and all patients had returned to their preinjury activity levels.Arthroscopic fixation by use of 1 anchor and 1 Pushlock is an easy, safe, and minimally invasive technique for treatment of displaced tibial intercondylar eminence fractures and does not require further surgery to remove fixation devices.Level of Evidence: Level IV, therapeutic case series

Clinical and epidemiological features of tibial tubercle avulsion fracture in Chinese adolescents

BackgroundTibial tubercle avulsion fracture is rare in children. Accumulated knowledge on clinical and epidemiological features of this fracture is of practical significance for clinical colleagues to deal effectively with such...

Suturing the Anterior Cruciate Ligament Using a No. 16 Intravenous Catheter Needle in Avulsion Anterior Cruciate Ligament Injury

Avulsion anterior cruciate ligament injuries are more common in pediatric patients. There are several methods of fixation available for these injuries (tibial intercondylar eminence fractures), such as the pullout suture technique, screw fixation, and suture anchor fixation. Currently, a pullout technique is widely used for fixation. We purpose a pullout technique method using a modified No. 16 intravenous catheter needle to suture the anterior cruciate ligament fiber instead of a suture hook or suture passer. We also use one anterior tibial tunnel for this arthroscopic pullout fixation technique to decrease the incidence of physeal injury in pediatric patients by using many tibial tunnels.

Tibial tubercle fractures in children and adolescents: a large retrospective case series.

To report patient characteristics, fracture types, treatment methods, early clinical outcomes and complications of children and adolescents treated for tibial tubercle fractures. Retrospective case series of patients 18 years old and younger treated for tibial tubercle fractures at a single institution from 1995 to 2015. Clinical and radiographic outcomes were reported at minimum six-month follow-up. In 228 patients, 236 tibial tubercle fractures were identified, of whom, 198 (87%) were males. Mean age and BMI was 14.3 years and 25.0, respectively. Pre-existing Osgood-Schlatter disease was identified in 31% cases and was most commonly associated with type I fractures (P < 0.001). Most fractures occurred while participating in athletics (86%). Initial treatment was surgical for 67% fractures. Type III fractures were most common (41%), followed by type I (29%). Type I fractures were most commonly treated nonoperatively (91%) and types II-V fractures were most commonly treated surgically (89%, P < 0.001). Compartment syndrome was identified in 4 (2%) patients, 3 of which had type IV fractures. Most patients returned to sports (88%). Tibial tubercle fractures are sports-related injuries and occur most commonly in adolescent males. They can be associated with pre-existing Osgood-Schlatter disease, a higher than average BMI, and a small but relevant risk of compartment syndrome. Following treatment, most patients return to sports participation.

Epidemiological Analysis of Avulsion Fractures in Dogs

Abstract Objective This study aimed to analyse the epidemiological data of canine appendicular avulsion fractures from three academic veterinary hospitals in the United States. Study Design A total of 114 avulsion fractures that presented to three study centres (teaching hospitals in New York, California, and Michigan) between 2008 and 2018 were analysed for avulsion type, breed, sex, body weight, age and affected side. Results The mean age for avulsion fractures was 1.6 years (±2.3 standard deviation), and side and sex were comparable (53% females and 54% left sided, only 2% bilateral). Tibial tuberosity fracture was the most common type, comprising 54% of all avulsion fractures, significantly more prevalent in younger and lighter dogs (p &lt; 0.001). There was no significant difference in avulsion type, breed, sex, weight, age and affected side among three study centres (p = 0.66). Conclusion The most common avulsion fractures were tibial tuberosity fractures, which tend to occur in young, small dogs. There is no sex or side predilection for avulsion fractures noted in this study, although the effect of neuter could not be determined. There were no differences in fracture characteristics among the three different geographical locations in the United States.

Growth of The Pediatric Knee Meniscus: A Cadaveric Study

Objectives:The menisci of the knee (Figure 1) play a critical role in maintaining structural integrity, as well as in load bearing and shock absorption. In adolescent patients, meniscal tear is a very common sports injury, and is frequently associated with concomitant traumatic injuries including tibial eminence fracture or ACL tear. Depending on the severity of meniscal tear, surgical treatment options include arthroscopic partial or total meniscectomy, with a reported 78-88% success rate. Given the high incidence of pediatric meniscal injuries and reliance on landmarks to guide arthroscopic meniscus repair, surprisingly few human pediatric cadaveric studies are reported in the current literature. The primary purpose of our research was to evaluate the rates at which different zones of the meniscus rim lengthen with age during early adolescence. Our null hypothesis was that meniscus rim length is unrelated to patient age, tibial plateau width, or to lateral-medial meniscus width.Methods:From images of 29 dissected cadaveric knee specimens between 1 month and 132 months of age obtained on a copy stand (14 left knee, 15 right knee), we made direct length measurements from the inner to outer meniscus rim at 45 degree intervals (12, 1:30/10:30, 3:00/9:00, 4:30/7:30 o’clock, 6 o’clock) using Autodesk Fusion 360 software (Figure 2). We also measured width between the outer medial and lateral meniscus rims, as well as CT measurements of coronal and sagittal width of the tibial plateau using OsiriX DICOM software. Generalized linear models were used to evaluate the associations of meniscal length measurements with age, tibial width, and meniscal width measurements. All statistical analyses were completed with a two-sided level of significance of 0.05.Results:All meniscal length measurements were predicted to increase significantly as age increases (p < 0.01 for all), as coronal tibial width increases (p < 0.05 for all), and as lateral-medial meniscal width increases (p < 0.001 for all). Other than the lateral 3 o’clock measurement (p = 0.119), all meniscal length measurements were predicted to increase significantly as sagittal tibial width increases (p < 0.05 for the rest). Interestingly, the posterior zones of the medial meniscus (6 o’clock and 4:30/7:30 o’clock) were found to increase in length at a faster rate than the anterior zones (Figure 3), which supports our hypothesis that increased weight bearing is correlated with meniscus growth. The same length correlation was not identified in the lateral meniscus. Furthermore, the anterior zones of the medial meniscus (12 o’clock and 1:30/10:30 o’clock) were found to have the slowest rate of growth, presumably due to reduced weight bearing function anteriorly.Conclusions:We reject our null hypothesis that meniscus rim length is unrelated to age, tibial plateau width, or to lateral-medial meniscus width. Surprisingly, the posterior zones of the medial meniscus were found to grow at a faster rate with age compared to the anterior zones, which we attribute to the effect of increased weight bearing experienced by the posterior zones during knee bending exercise. Additionally, the anterior, lesser-weight bearing regions of the medial meniscus were found to develop at the slowest rate out of all zones measured. Further studies are underway to generalize these observations to all adolescent patients. This information will be useful for meniscus repair and transplantation surgical planning.

Arthroscopic tri-pulley Technology reduction and internal fixation of pediatric Tibial Eminence fracture: a retrospective analysis

BackgroundFixing a tibial eminence fracture with a tri-pulley is a new technique. The purpose of this study was to present the early clinical outcome of arthroscopic tri-pulley suture fixation for tibial eminence fractures in children.MethodsTwenty-one pediatric patients with type II or type III anterior tibial eminence fractures were included in this retrospective study. All Patients underwent surgical fixation by tri-pulley technology and were followed up for at least 24 months. They were evaluated preoperatively and postoperatively by physical, X-ray, and computed tomography (CT) examination and subjectively with the International Knee Documentation Committee (IKDC), and Lysholm questionnaires.ResultsThe patients included 12 males and 9 females; mean age, 12.5 years (range, 8 ~ 16 years). They were followed-up for a median of 27 months (range, 24 ~ 39 months). We did not find post-operative instability in any of the patients by physical examination. The KT-2000 difference of both knees decreased from 9.3 ± 1.2 mm preoperatively to 2.6 ± 0.8 mm 24 months postoperatively (P < 0.001); the IKDC subjective knee evaluation score improved from 43.1 ± 13.2 preoperatively to 83.8 ± 6.3 postoperatively (P < 0.001); and Lysholm improved from 48.3 ± 6.21 to 87.1 ± 9.8 (P < 0.001). No unhealed fractures or epiphyseal damage were reported in the postoperative X-ray and CT.ConclusionsArthroscopic tri-pulley fixation technology may provide a suitable technique for repair of tibial eminence fractures in skeletally immature patients.Level of evidenceCase series; Level of evidence IV.

Simultaneous ipsilateral tibial tuberosity and patellar fractures in an adult patient

We present the case of a 56-year-old man who sustained a tibial tuberosity fracture with an associated patellar fracture. In the adult population there are only a few documented cases of tibial tuberosity fractures. This is only the second recorded case of bifocal patella tendon avulsion. The patient was managed successfully by fixation of the tibial tuberosity alone as the patella fracture was undisplaced and the patella retinaculum intact. A key point was screening the patella fracture at time of fixation to aid this decision. We achieved a good outcome at one year with internal fixation and early mobilisation.

The clinical effect and safety of the treatment of tibia intercondylar eminence fracture with cannulated screw and suture fixation under arthroscope: Protocol for a systematic review and meta-analysis of randomized controlled trials.

Background:The clinical effects and safety over the treatment of tibia intercondylar eminence fracture (TIEF) with cannulated screw and suture fixation were evaluated under arthroscope systematically, providing evidence-based medical support for the selection of surgical methods in terms of minimally invasive arthroscopic treatment for TIEF.Methods:The English databases of PubMed, EMBASE, Cochrane Library, CNKI, SinoMed, VIP, and Wanfang databases were searched by computer. The randomized controlled trials were conducted to compare the clinical effects of TIEF with cannulated screw and suture fixation under arthroscope. The retrieval period is from the beginning of database building to January 2020. There is no language restriction. Chinese databases are searched by keywords, while English databases are searched by the combination of subject words and free words. According to the retrieval strategy, the two evaluators will lead the conforming documents into Note Express for repeated literature screening, and the two evaluators will extract and cross-check the conforming documents according to the pre-designed data extraction table. Two researchers adopted the modified Jadad scale independently to evaluate the quality of the literature. The RevMan 5.3 version software provided by the Cochrane Collaboration Network was adopted for statistical analysis.Results:The study will strictly review and extract the data included in the literature, and scientifically make statistical analysis for the pre-set outcome indicators. All the research processes will be conducted in strict accordance with the guidance of system evaluation. In this study, the differences between cannulated screw fixation and suture fixation under arthroscopy will be evaluated by comparing the relevant outcome indicators. All the results of this study will be published openly in a highly influential professional academic journal.Conclusion:The paper adopted Cochrane system evaluation method to collect and sort out the published literature about the treatment of tibial eminence fracture between cannulated screw fixation and suture fixation under arthroscopy, and to compare the clinical efficacy and safety of the two fixation methods utilizing meta-analysis and comparison of related outcome indicators. Through this study, we will draw a positive conclusion, which will provide a basis for the better treatment of tibial eminence fracture.PROSPERO registration number:PROSPERO CRD42020168433.

Clinical results of triple tibial osteotomy treatment in cranial cruciateligament-deficient dogs

Canine cranial cruciate ligament ruptures have become common with improved nutrition and nonselective breeding strategies. This study assessed 7 dogs of various breeds and ages with the diagnosis of cranial cruciate ligament ruptures. The triple tibial osteotomy TTO method was used to treat the rupture. All of the dogs were admitted to the clinic for varying degrees of lameness. Diagnosis was confirmed using both clinical and radiologic examinations. Body weights of the dogs were between 12 and 65 kg. Informed consent was given by the owners prior to surgery. Postoperatively, early evaluations were made using periodic radiographs and clinical examinations, but long-term evaluations were performed by phone interviews due to economic and other limitations by the owners. The TTO operation method was completed successfully in all of the cases and only with Case 5 was a major complication encountered tibial tuberosity fracture from the distal pivot hole . In 3 cases, the minor complication of wound contamination occurred due to poor wound care by the owners of the dogs. Owners were advised to restrict mobilization for a week following cast removal. Early, mid-, and long-term postoperative results showed functional recovery in all of the cases. All of the dogs returned to their pretrauma lives and those that had chronic symptoms had a significant increase in their mobility when compared to their previous states after cranial cruciate ligament rupture.

CORR Synthesis: Can Guided Growth for Angular Deformity Correction Be Applied to Management of Pediatric Patellofemoral Instability?

CORR Synthesis: Can Guided Growth for Angular Deformity Correction Be Applied to Management of Pediatric Patellofemoral Instability?

Subintermeniscal Ligament Pullout Suture Technique for Anterior Cruciate Ligament Avulsion Fracture Fixation-AIIMS Technique.

Many methods have been described, including pullout suture technique, for arthroscopic fixation of displaced tibial eminence fracture. We are describing our technique of pullout suture, which is a modification of previously described techniques. We passed two sutures arthroscopically through anterior cruciate ligament (ACL) just above the avulsed fragment and then pulled them out through medial and lateral bone tunnel in anterior aspect of crater in tibial plateau. The third suture passed through ACL was pulled out anteriorly under the transverse intermeniscal ligament through a submeniscal route. All sutures were tied under tension to a screw post placed on the anterior tibia after reducing the avulsed bone fragment. Our technique provides good reduction and even overreduction of the fragment. It also provides good initial fixation strength to work against displacing forces even in small and comminuted bony fragment. This is helpful for achieving adequate stability of knee, complete extension of knee, early rehabilitation, and quicker recovery.

Cannulated screw fixation versus high-strength suture fixation in arthroscopy of tibial intercondylar fracture

Objective To compare the cannulated screw fixation versus high-strength suture fixation in arthroscopy of tibial intercondylar fracture. Methods A retrospective analysis was performed of the 31 patients with tibial intercondylar fracture who had been treated from February 2015 to February 2018 at Department of Orthopaedics, Beijing Renhe Hospital. They were 18 males and 13 females with an average age of 34.3 years (range, from 21 to 51 years). Arthroscopic cannulated screw fixation was conducted in 13 patients (screwing group), 5 of whom were McKeever type Ⅱ and 8 of whom McKeever type Ⅲ. Arthroscopic high-intensity suture fixation was used in 18 patients (suture group), 6 of whom were McKeever type Ⅱ and 12 of whom McKeever type Ⅲ. The 2 groups were compared postoperatively in terms of operation time, hospitalization time, fracture healing time, Lysholm knee scores and rate of secondary operation. Results The 2 groups were comparable because there were no significant differences in preoperative general data between them (P>0.05). All the patients were followed up for 12 to 44 months (mean, 24.8 months). For the screwing and suture groups, respectively, operation time was 91.6 min±7.6 min and 91.9 min±7.4 min, hospitalization time 11.5 d±2.9 d and 11.4 d±2.3 d and fracture healing time 3.3 mon±0.5 mon and 3.3 mon±0.6 mon, showing no significant differences between the 2 groups (P>0.05). By the Lysholm scores at 12 months after operation, the screwing group scored from 65 to100 points with an excellent and good rate of 92.3% (12/13), and the suture group from 60 to 100 points with an excellent and good rate of 94.4% (17/18), showing no significant difference between the 2 groups (P>0.05). Ten patients (76.9%) in the screwing group had secondary arthroscopy to remove the implants but none in the suture group did. Conclusions Both cannulated screw fixation and high-strength suture fixation can achieve satisfactory clinical results in the arthroscopy of tibial intercondylar fractures, but the latter may lead to a lower rate of secondary operation. Key words: Arthroscopy; Fracture fixation, internal; Bone nails; High strength suture; Tibial eminence fracture

Pediatric tibial eminence fracture treatment: A case series using a bioabsorbable screw

BackgroundPediatric tibial eminence fractures constitute a complex injury with multiple treatment options. We have described a technique that combines direct visualization through an open approach and stable fixation using a bioabsorbable screw. The purpose of this study is to describe our surgical technique for tibial eminence fractures and to compare the radiographic and functional outcomes to previous open or arthroscopic methods. MethodsWe retrospectively reviewed a series of five pediatric patients who underwent open reduction and internal fixation of a tibial eminence fracture with a headless, bioabsorbable poly-L lactic acid (PLLA) screw (Bio-Compression screw, Arthrex Inc, Naples, FL) from 2016 to 2017. The surgical technique involves an open approach, direct fracture reduction, and fixation with a PLLA screw without violating the epiphyseal plate. Postoperative assessment was quantified using the Lysholm knee score (LKS), knee arc of motion (AOM), presence of a pivot shift or Lachman, and knee radiographs with an average of 18.4 months of follow-up. ResultsFive patients (average age of 11.3 years) were treated with a biobsorbable screw and followed for an average of 18.4 months. Average LKS was 99.6, AOM was 98.4%, all patients had negative pivot shift and Lachman exams, and all patients went on to radiographic union. No patients required re-operation or implant removal. ConclusionsThe goals of tibial eminence fracture management are fracture union, restoring knee stability, and regaining normal knee motion and kinematics. Our study demonstrates that open treatment with a bioabsorbable screw is an excellent alternative surgical method as it reliably results in rigid fixation, fracture union, excellent knee function scores, and it mitigates the possible need for hardware removal. Level of evidenceTherapeutic Level IV – Case series.