Tibial Intercondylar Eminence Fractures Research Articles

The Arthroscopic Three-Point Fixation for Anterior Cruciate Ligament Avulsion Fracture: Surgical Technique

Several arthroscopic repairs and fixation for tibial intercondylar eminence fracture have been developed for restoring anterior cruciate ligament function. Repairing the avulsion fragment with multiple-point fixation provides some benefits over a single-point fixation. It provides multidirectional force control, especially on the posterior part of the fragment, and produces area of compression. We propose a 3-point fixation technique for providing proper reduction and compression in large fragment anterior cruciate ligament avulsion fracture. This includes using hybrid intra-articular and tunnel pull-out suture fixation to provide good posterior reduction and fixation. The number of tunnels is decreased by using a suture anchor.

Clinical outcomes of arthroscopic single-tunnel double-line technique in treating tibial intercondylar eminence fractures

To evaluate clinical efficacy of single-tunnel double-line technique with tendoscopy in treating tibial intercondylar eminence fractures. From January 2016 to April 2020, 22 patients with tibial intercondylar eminence fractures were admitted, including 14 males and 8 females with a mean age of (34.8±5.9) years old ranging from 26 to 45 years old. The mean duration from injury to surgery was(11.2±4.1) days(ranged, 5 to15 d). All patients were treated with arthroscopic single-tunnel double-line technique. The fracture healing was evaluated according to X-ray. The Lysholm score, IKDC 2000 score and the anterior drawer test were used to evaluate efficacy before operation and at the latest follow-up. All patients were followed up, and the duration ranged from 12 to 75 months, with an average of(34.6±13.0) months. Lysholm score was (89.60±2.89) points at the latest follow-up, showing significant difference when compared with preoperative score which was (30.80±9.55)points(t=9.67, P<0.01). IKDC 2000 score was(80.00±6.17) points at the latest follow-up, showing significant difference when compared with preoperative score which was(24.60±7.21)points(t=11.41, P<0.01). One patient showed weakly positive of drauer test. Single-channel double-line technique could effectively fix bone block of intercondylar eminence with advantage of easy operation and minimally invasive, which could be applied to various types of tibial intercondylar eminence fractures.

Surgical treatment for a combined anterior cruciate ligament and posterior cruciate ligament avulsion fracture: A case report

BACKGROUNDIndependent avulsion fractures with anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL) attachment are relatively common among tibial intercondylar eminence fractures, and their postoperative outcomes are generally favorable. Conversely, huge avulsion fractures of the intercondylar eminence containing the attachment site of both the ACL and the PCL are extremely rare, and the reported clinical outcomes are poor.CASE SUMMARYWe describe a 30-year-old Japanese male's huge avulsion fracture of the intercondylar eminence of a tibia containing the attachment site of both the ACL and PCL, together with a complete tear of the medial collateral ligament and a partial tear of both the medial and lateral menisci caused by a fall from a high place. All of these injuries were treated surgically, with anatomical reduction and stable fixation. The limb function at 1 year post-surgery was excellent (Lysholm score: 100 points).CONCLUSIONAlthough this patient's complete surgical repair was complex, it should be performed in similar cases for an excellent final clinical outcome.

Arthroscopic suture-fixation of anterior tibial intercondylar eminence fractures by retensioning of the ACL and hollowing of the tibial footprint: Objective and subjective clinical results in a paediatric population

IntroductionAnterior tibial intercondylar eminence fractures (ATIEF) of the knee are rare in children. They are associated with prefracture intraligamental distention of the anterior cruciate ligament (ACL). ObjectiveThe objective of this study was to evaluate the subjective and objective clinical results of an arthroscopic surgical technique by suture-fixation of the fracture and tensioning of the ACL through hollowing of the tibial footprint. HypothesisSuture-tensioning of ATIEF arthroscopically helps to achieve treatment objectives by leaving the knee joint free of any hardware. Materials and methodsThis single-operator monocentric retrospective study involved twenty children operated on over a period of 2-years and 10 months, from March 2013, and with a minimum of one-year follow-up. Surgery was indicated for Stage II to IV fractures according to the Meyers and McKeever classification. Type I fractures were excluded. Seventeen out of 20 patients were reviewed. The median age was 12 years at the time of surgery and the mean follow-up was 28 months. The fractures were 5 of stage II, 9 of III and 3 of IV. The scores of Lysholm, objective and subjective IKDC were collected. Residual objective laxity was measured using the GNRB arthrometer at 150N. A standard X-ray evaluation permitted detection of possible growth disorders. ResultsAt 28 months of mean follow-up, the mean scores of Lysholm and subjective IKDC were 99 (95; 100) and 97 (92; 100), respectively. As for the objective IKDC, 14 knees were rated A and 3 were rated B. The mean differential residual laxity via GNRB was 0.94mm (0; 2.4). No radiological growth disorder was observed at the last follow-up. ConclusionThe ACL suture-tensioning technique is simple and reliable. It also preserves the joint of the adult to remain free of any residual hardware. Level of evidenceIV; retrospective cohort study.

Anatomical fixation of tibial intercondylar eminence fractures in children using a threaded pin with an adjustable lock

IntroductionTibial intercondylar eminence fractures are a rare pathology causing anterior laxity of the knee, which requires anatomical reduction and a stable osteosynthesis. The aim of this study was to present the clinical results of reinsertion in anatomical position of these fractures, in the paediatric population, using a threaded pin with an adjustable lock. HypothesisOur hypothesis was that the clinical results would be satisfactory and comparable to the literature. MethodThis retrospective, monocentric study involved 34 consecutive patients with tibial intercondylar eminence fractures, divided into 55.9% with type 2, 35.2% with type 3, 8.8% with type 4 according to Meyers & McKeever, operated on between March 1999 and March 2018. Assessments were performed at a minimum follow-up of 1-year and included the Lysholm, subjective International Knee Documentation Committee (IKDC) and Tegner activity scores, and the measurement of anterior knee laxity by the KT1000. ResultsAt the average follow-up of 8.8 years, 7 patients were lost to follow-up, 2 required anterior cruciate ligament reconstruction. Pathological residual laxity was present in 25% of cases and instability in 16%. The average Lysholm score was 93.1±9.8, the average subjective IKDC was 93.8±6.4 and the average Tegner score was 5.6±1.5. The average anterior laxity of the knee was 0.7±2.0mm. ConclusionThe anatomical reinsertion using a threaded pin with an adjustable lock for tibial intercondylar eminence fractures in a paediatric population provides good functional results and is comparable to the data in the literature. Level of evidenceIV; retrospective.

Arthroscopically Assisted Cannulated Screw Fixation for Treating Type III Tibial Intercondylar Eminence Fractures: A Short-Term Retrospective Controlled Study.

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.

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

Tibial intercondylar eminence fracture is a rare fracture and is commonly treated with suture, screw or bio-absorbable nail. Current literature includes little information regarding outcome of surgically treatment with bio-absorbable nails. The purpose of this study was to report the clinical and functional outcomes in patients with tibial intercondylar eminence fractures arthroscopically treated with bio-absorbable nails. The study design was retrospective follow-up. Sixteen patients, age 11-16years, were surgically treated with bio-absorbable nail following an intercondylar eminence fracture. Thirteen patients participate in the present follow-up study. The median follow-up time was 6.5years. The main outcome measurement was the Knee Injury and Osteoarthritis Outcome Score (KOOS). Secondary outcome measurements consisted of: Eq5d-5L questionnaire, knee pain, knee laxity, range of motion (ROM), muscle strength, gait analyses, radiological outcomes, activity and level. The median KOOS scores for the five subscales were: pain 98.5 (19-100), symptoms 90.5 (54-100), ADL 100 (22-100), sport 87.5, (0-100) and QOL 88.0 (13-100), indication satisfactory outcome. Low level of gait asymmetry was observed. Almost balanced muscle strength between the injured and non-injured leg for knee extension and knee flexion strength was observed. Measurement of anterior knee laxity showed 12 patients with a knee laxity between -1 and 2mm. The examination of intercondylar eminence displacement at the time of follow-up showed that 12 patients had a displacement of 2mm or less. This case series demonstrates satisfactory patient-reported and functional outcomes in the treatment of intercondylar eminence fractures in children and adolescents with bio-absorbable nails.

Preliminary clinical outcomes of the double-row anchor suture-bridge technique for the fixation of tibial intercondylar eminence fractures in adults: a 12-months minimal follow-up

BackgroundTibial intercondylar eminence avulsion fractures occur primarily in adolescents and young adults. However, the incidence of such fractures is increasing in adults, concurrent with an increase in sports injuries and traffic accidents. This study describes the fixation-based double-row anchor suture-bridge technique, a novel technique for treating tibial intercondylar eminence fractures in adults; and evaluates its preliminary clinical outcomes.MethodsA retrospective evaluation of adult patients with tibial intercondylar eminence fractures treated at our institution from June 2016 to June 2018 was conducted. Seven such patients, treated with the anchor suture-bridge technique, were included. All patients were assessed for knee joint range of motion (ROM), Lysholm knee score, International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form score, Tegner activity score pre-surgery, and the healing of the fracture at 3, 6 and 12 months minimal post-surgery follow-up.ResultsPatients were followed for a mean of 12.43 months (range 9-15 months). By the final follow-up, all fractures had fully healed. The mean Lysholm score improved from 27.86 (range, 2 to 54) pre-surgery to 88.14 (range, 81 to 100) 3 months post-surgery (p < 0.05). Similarly, the mean IKDC score improved from 48.86 (range, 43 to 55) to 84.29 (range, 75 to 90) (P < 0.05); and the mean Tegner activity score improved from 1.71 (range, 0 to 4) to 3.29 (range, 2 to 4) (p < 0.05). Furthermore, knee joint ROM, Lysholm scores, IKDC scores, and Tegner activity scores displayed excellent outcomes at the 6 and 12 months minimal follow-up.ConclusionThe arthroscopic anchor suture-bridge technique is a valid and secure method for achieving effective fixation of tibial intercondylar eminence fractures in adults.

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

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.

Arthroscopic treatment of type III tibial intercondylar imminence avulsion fracture with pullout sutures in skeletally immature patients

Study design This was a retrospective study. Objective of the study The objective of this study was to evaluate the results of arthroscopic reduction and internal fixation of type III tibial intercondylar imminence avulsion fracture by pullout nonabsorbable suture technique in skeletally immature patients. Background Tibial intercondylar eminence fracture is an intraarticular avulsion fracture of the anterior cruciate ligament (ACL) insertion. Traditionally, they can be seen between 8 and 14 years of age, and they are rare among those under the age of 8 years. The reported incidence is three per 100 000 children each year. The best functioning results are obtained after arthroscopic reduction and internal fixation by pullout sutures technique. Patients and methods Between March 2010 and March 2012, we received 14 patients referred from the emergency department. There were 10 males and four female patients. The right knee was involved in nine cases and the left knee in five cases. The median age of the patients was 14 years (13–15 years). The time between injury and surgery was 6 days (4–12 days). The inclusion criteria were displaced tibial eminence fractures (type III) in skeletally immature patients. Tibial eminence fractures were defined according to the classification of Meyers and McKeever modified by Zaricznyj. An arthroscopic standard anterolateral portal, an anteromedial portal, and a viewing accessory high anterolateral portal were utilized. The fracture bed is cleared of debris and the fracture fragment is reduced. The ACL tibial guide is utilized to drill two 5-mm tunnels on both sides of the fracture fragment to the upper anteromedial tibia. Two no. 5 Ethibond sutures were passed through the ACL substance close to the bone fragment by suture passing instrument. The sutures were the tied at the anteromedial tibia. Results The median follow-up was 24 months. The mean IKDC score was 91 (range, 87–100). The IKDC grades were A (normal) in 10 (72%) patients and B (nearly normal) in four (28%) patients. The mean preinjury Tegner score was 5 (range, 3–7), and at follow-up evaluation, the mean Tegner score was 4 (range, 3–6). The mean preoperative Lysholm score was 42 (range, 32–56); the mean postoperative Lysholm score was 92 (range, 88–100). Conclusion Arthroscopic reduction and internal fixation of tibial imminence avulsion fracture by pullout nonabsorbable suture technique in skeletally immature patients is a safe and effective method to treat this lesion.

ARTHROSCOPIC FIXATION OF TIBIAL INTERCONDYLAR EMINENCE FRACTURE BY FIBER WIRE SUTURE AND U SCREWS IN ADOLESCENT ATHLETES

Objective: We aimed to present our experience on arthroscopic management of tibial intercondylar eminence fracture in adolescent athletes. Methods: This was a case series of 9 adolescents (7 males, 2 females) aged 10-16 years diagnosed with tibial intercondylar eminence fracture following a sports activity. According to Meyers and McKeever classification, 4 patients had Type IIIA, 3 had Type IIIB, and 2 patients had Type II fracture. Following percutaneous arthroscopic reduction, the fragments of the fracture were fixed internally and anterior cruciate ligament was reconstructed through two 2.4 mm parallel tunnels at the level of anterior tibia by using fiber wire suture and U screws. Anterior tibial displacement was measured by KT-1000 knee arthrometer, and Lysholm Knee Scoring Scale was used for the patient-reported outcomes. Results: The duration of operation was 31.6±8.9 min. The patients were followed up for 37.1±19.1 months. Theanterior tibial displacement relative to the femur was 1.4±0.7 mm. TheLysholm score was 95.8±3.1. None of the patients developed infection. The complete fracture healing was obtained in all patients. Conclusion: Arthroscopic reduction and internal fixation by fiber wire suture and U screws provide perfect anatomic and functional outcome for displaced Type II and Type III tibial intercondylar eminence fracture in adolescent athletes.

HOFFA’S FRACTURE WITH IRREDUCIBLE PATELLAR DISLOCATION: APPROACH TO AVOID COMPLICATIONS IN A RARE INJURY

Hoffa’s fracture is coronal oriented fracture of distal femur with the fracture line extending through the femoral condyles. Hoffa’s fracture is rarely associated with ipsilateral femur and tibia fractures. Proper clinical examination and radiographic evaluation is necessary to diagnose associated injuries around the knee joint with Hoffa’s fracture. Closed reduction of dislocated patella in emergency room and field triage should be avoided to prevent patellar tendon incarcenation, patellar tendon rupture and osteochondral damage. We report a rare case of Hoffa’s fracture with irreducible patellar dislocation and tibial intercondylar eminence fracture following road traffic accident.

Clinical research on suture anchor fixation for the treatment of avulsion fracture of tibial intercondylar eminence under arthroscopy

To evaluate the early clinical effects of suture anchor fixation for the treatment of avulsion fracture of tibial intercondylar eminence under arthroscopy. From July 2012 to January 2015, 22 patients with the avulsion fracture of tibial intercondylar eminence were treated with arthroscopic suture anchor fixation. There were 12 males and 10 females, with an average age of 22.8 years old(ranged, 18 to 33 years old). Nine patients had the fractures in the right knee and 13 patients had the fractures in the left knee. The mean duration from injury to surgery was 6.8 days(ranged, 3 to 11 days). According to the improved Meyers-McKeever classification, 13 cases were type II, 7 cases were type III, and 2 cases were type IV. The clinical outcomes were evaluated by the range of motion, the Lysholm score, the IKDC 2000 subjective knee score, the axial shift test, and the anterior drawer test. All the incisions healed by first intention, and no complications occurred. All the patients were followed up, and the mean duration was 32.8 months (ranged, 18 to 42 months). The knee range of motion was improved from preoperative (49.37±7.69) ° to (126.38±5.58) °at the latest follow-up(P<0.01). Lysholm score was improved from preoperative 43.4±5.6 to 79.2±6.2 at the latest follow-up(P<0.01). And the IKDC 2000 score was improved from preoperative 52.6±6.2 to 81.4±5.7 at the latest follow-up(P<0.01). At the latest follow-up, the patient underwent physical examination. One patient had a positive result of axial shift test at the 18th month after operation with grade II laxity of anterior cruciate ligament. One patient had a weakly positive result of anterior drawer test at the 24th month after operation. Absorbable suture anchor fixation for the treatment of avulsion fracture of tibial intercondylar eminence under arthroscopy can provide accurate reduction and stable fixation, which can be applied to treat all types of fractures including comminuted fracture, and it is not necessary to remove the implant in the second operation.

Arthroscopic treatment of displaced tibial eminence fractures using a suspensory fixation.

Background:Avulsion fractures of the tibial intercondylar eminence are fairly common injuries requiring surgery for the optimal functional outcome. The purpose of this study was to assess the clinical and radiological outcomes of an arthroscopic treatment of displaced tibial intercondylar eminence fractures using a suspensory device.Material and Methods:Five patients with type 2 and 3 displaced tibial intercondylar eminence fractures who received an arthroscopically assisted fixation using a double button device were enrolled from 2011 to 2012. Clinical assessment included the patient demographics, cause of injury, the delay before surgery, time for surgery, time to return to work and sport, the International Knee Documentation Committee (IKDC) and Lysholm knee scores. Stability was measured with the KT-2000 arthrometer with a force of 134 N. A side to side difference on the KT-2000 examination superior to 3 mm was considered as a significant and abnormal increase in the anterior translation. Radiological examination consisted of anteroposterior and lateral radiographs, as well as computed tomography (CT) scan of the affected knee. Clinical and radiological followup was done at 1, 2, 3, 6, and 12 months postoperatively and at final followup. CT-scan was performed before surgery and at 3 months followup.Results:The median age of patients was 31 years. Mean followup was 27 ± 5.1 months. The average delay before surgery was 3 days. At final followup, the mean IKDC and Lysholm knee scores were, 93.9 and 94.5 respectively. All patients had a complete functional recovery and were able to return to work and to resume their sport activities. No secondary surgeries were required to remove hardware. No complication was noted. Bony union was achieved in all patients.Conclusion:The arthroscopic treatment of displaced tibial intercondylar eminence fractures using a suspensory system provided a satisfactory clinical and radiological outcome at a followup of 2 years.

A new technique for arthroscopic reduction and fixation of displaced tibial intercondylar eminence fractures, using suture anchor and EndoButton system.

The study aims to describe a less invasive technique for displaced tibial intercondylar eminence fractures, using only one bone tunnel with suture anchor and EndoButton system. Seventeen patients were followed up after arthroscopic fixation for tibial eminence fractures using suture anchor and EndoButton. The patients were followed with clinical examinations such as Lysholm, Tegner, and International Knee Documentation Committee (IKDC) rating scales. Radiographic assessments were also performed during the follow-up for evaluating the healing of the fracture. There were 14 male patients and 3 female patients with 10 right knees, and 7 left knees included. All the fractures healed anatomically at final follow-up. Also, no clinical signs of anterior cruciate ligament deficiency were detected. The mean Lysholm score improved significantly from 74.72 ± 3.24 (range from 70 to 79) to 96.2 ± 2.54 (range from 89 to 98) ( p < 0.001). The IKDC category was abnormal or severely abnormal preoperatively and all the patients improved to normal or nearly normal at final follow-up. The Tegner score also improved significantly postoperatively from 3.45 ± 1.02 to 6.34 ± 1.22 ( p < 0.001). The study demonstrated that the procedure is safe and effective, which can be another option for tibial intercondylar eminence fractures.

Arthroscopic treatment of intercondylar eminence fractures with intraepiphyseal screws in children and adolescents

IntroductionTibial intercondylar eminence fracture rarely occurs in childhood. Its treatment requires anatomic reduction to provide knee stability and a rigid fixation to minimize postoperative immobilization time. HypothesisArthroscopy combined with fluoroscopy with intra-epiphyseal ASNIS screw fixation can meet the requirements of this treatment. Material and methodsThe series comprised 24 patients (mean age: 11 years) with Meyers and McKeever type II tibial intercondylar eminence fractures (n=15) or type III (n=9), operated on between 2011 and 2013. Fixation with 4-mm ASNIS screws was placed arthroscopically. The demographic data, associated lesions, radiological union, stability, functional result, and the Lysholm score were evaluated. ResultsWith a mean follow-up of 2 years, the mean Lysholm score was 99.3 for type II and 98.6 for type III fractures. At the 6th postoperative week, range of motion in the operated knees was identical to the healthy knees. At the 12th postoperative week, there was no sign of anterior laxity. Twelve cases included meniscal entrapment, but no significant difference was observed in the functional results. Discussion, conclusionASNIS screw fixation under arthroscopy can be successfully applied in the treatment of types II and III tibial intercondylar eminence fractures in children. This technique provides excellent stability, allows early weigh-tbearing, and preserves function of the knee and its growth. Level of evidenceIV, retrospective study.

Arthroscopic double strand wire fixation anteriorly and posteriorly to anterior cruciate ligament for tibial intercondylar eminence fracture

To explore the clinical outcomes of arthroscopic double strand wire fixation anteriorly and posteriorly to anterior cruciate ligament (ACL) for tibial intercondylar eminence fracture. From January 2009 to February 2012, 12 patients with tibial intercondylar eminence fracture were selected. There were 4 males and 8 females with an average age of 19.5 ± 10 (10-50) years. Time from injury to operation was 4 days to 2 years. All cases belonged to Meyers-Mekeever type II and type III. Arthroscopic double strand wire compressive fixation was performed anteriorly and posteriorly to ACL. Other measures included postoperative rehabilitation and supports with brace in knee extension when weight-bearing for 4-6 weeks. The average follow-up period was 15.6 (6-30) months. Final clinical results showed good range of motion and good knee stability. On postoperative radiology, there were good reduction of intercondylar eminence fracture and excellent healing. There was no occurrence of wire rupture. Postoperative IKDC and Lysholm scores were excellent (n = 10) and good (n = 2). There was no such complication as fragmentation of intercondylar eminence fracture bone, neurovascular injury or infection. Arthroscopic double strand compressive fixation for tibial intercondylar eminence fracture may be easily performed without injury to ACL substance. The reduction is both stable and reliable. And the clinical outcome is excellent.

Injuries of ACL with Avulsion of Bone Fragment from Tibial Intercondylar Eminence in Children and Adolescents

Experience in arthroscopic treatment of 54 patients aged 5-18 years with ACL injury and bone fragment avulsion from the tibial intercondylar eminence is presented. Type I injury (by Meyers &amp; McKeever - Zaricznyi classification) was diagnosed in 2 %, type II - in 49%, type III - in 40% and type IV - in 9% of patients. In patients with type I injury arthroscopic intervention was performed for concomitant injuries diagnosis and knee joint sanitation. In patients with II-IV types of injury arthroscopic osteosynthesis of tibial intercondylar eminence fractures with wire loop by original technique was performed. Excellent results were achieved in 44 (81.1%), good - in 7 (12.1%) and satisfactory - in 3 (6.8%) patients. Neither complications nor cases of nonunion were noted. Advantages of the proposed technique are the minimal traumatization of tibial growth zone, rigid fracture fixation, possibility to use this method of fixation in comminuted fractures

Injuries of ACL with Avulsion of Bone Fragment from Tibial Intercondylar Eminence in Children and Adolescents

Experience in arthroscopic treatment of 54 patients aged 5-18 years with ACL injury and bone fragment avulsion from the tibial intercondylar eminence is presented. Type I injury (by Meyers &amp; McKeever - Zaricznyi classification) was diagnosed in 2 %, type II - in 49%, type III - in 40% and type IV - in 9% of patients. In patients with type I injury arthroscopic intervention was performed for concomitant injuries diagnosis and knee joint sanitation. In patients with II-IV types of injury arthroscopic osteosynthesis of tibial intercondylar eminence fractures with wire loop by original technique was performed. Excellent results were achieved in 44 (81.1%), good - in 7 (12.1%) and satisfactory - in 3 (6.8%) patients. Neither complications nor cases of nonunion were noted. Advantages of the proposed technique are the minimal traumatization of tibial growth zone, rigid fracture fixation, possibility to use this method of fixation in comminuted fractures