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Pediatric and Adolescent Tibial Eminence Fractures: Arthroscopic Cannulated Screw Fixation

Reynders, Peter MD; Reynders, Katrien MD; Broos, Paul MD

Journal of Trauma and Acute Care Surgery: July 2002 - Volume 53 - Issue 1 - p 49-54
Original Articles

Background  Fractures of the intercondylar spine of the tibia are enigmatic injuries. The mechanism of injury remains obscure, and appropriate treatment is unclear.

Methods  The authors analyzed a series of 26 cases of displaced fractures of the intercondylar eminence of the tibia treated with an arthroscopically placed, intrafocal screw with spiked washer. The patients were reviewed after a minimum follow-up of 24 months and a maximum of 8 years.

Results  Sixteen patients had a type II tibia eminence fracture according to Meyers and McKeever (mean age, 15 years; male/female ratio, 11:5). Ten patients had a type III tibia eminence fracture (mean age, 17 years; male/female ratio, 1:1). We encountered neither stiffness nor iatrogenic chondral abrasion. Only three patients with type II had no laxity. The 13 other patients in this fracture group had a minor laxity without correlation with the clinical result. In four patients with a type III lesion, a residual laxity without functional deficit was noticed. In two cases with a type III lesion, a reconstruction of the anterior cruciate ligament was necessary 3 years after trauma. In four patients with a type III fracture, the fragment remained elevated, with minor impairment of the mobility (extension lag). No mechanical failure or infection was seen in this series.

Conclusion  The authors found the intrafocal screw fixation for displaced fracture of the intercondylar eminence to be a reliable and safe technique, although complete restoration of the anteroposterior knee stability was seldom seen.

From the Department of Traumatology, University Hospital of Gasthuisberg, Leuven, Belgium.

Submitted for publication November 19, 2000.

Accepted for publication February 6, 2002.

Address for reprints: P. Reynders, MD, Department of Traumatology, University Hospital of Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium.

© 2002 Lippincott Williams & Wilkins, Inc.