Arthroscopic suture fixation of comminuted tibial spine fractures-a prospective study

  • Dr Kumar Shantanu Assistant Professor, Department of Orthopaedics, King George’s Medical University, Lucknow, UP, India
  • Dr Sudhir Shyam Kushwaha Senior Resident, Department of Orthopaedics, King George’s Medical University, Lucknow, UP, India
  • Dr Shailendra Singh Assistant Professor, Department of Orthopaedics, King George’s Medical University, Lucknow, UP, India
  • Dr Deepak kumar Assistant Professor, Department of Orthopaedics, King George’s Medical University, Lucknow, UP, India
  • Dr Vinnet Sharma Professor & Head, Department of Orthopaedics, King George’s Medical University, Lucknow, UP, India
Keywords: Tibialspine, Arthoscopic suture fixation, ACL

Abstract

Introduction:Tibial spine fractures are common injuries and various techniques have been described for the fixation. The purpose of the article is to make familiar with thearthroscopic fixation of the anterior cruciate ligament bony avulsion injuries using non absorbable sutures and simple methods and instruments. Adequate reduction, anterior cruciate ligament integrity and regaining the bio-mechanics of the knee are the ultimate goal to be achieved failing which non union and malunion ensues. This technique has resulted in achieving excellent results and thus avoiding complications like joint laxity, flexion deformity&pain.

Methods:Twenty one patients underwent arthroscopic suture fixation of the comminutedtibial spine fractures. Mean age of the patient was 24.28 years (range 16 to 38 years). All of the patients belonged to the Meyer type IV. The mean duration of follow up was 15.5 months with a minimum of one year follow-up.

Results:All patients showed negative Lachman test except one having grade 1 positive lachman. No patient showed extension loss. 90.4 % (n=19) patients had an IKDC grade A while two patients belonged to grade B. All patients returned to their previous activity level.

Conclusion:The above excellent results show that arthroscopic suture fixation of the comminutedtibial spine is promising and reliable technique to achieve the best biomechanics of the knee.

Downloads

Download data is not yet available.

References

Mann MA, Desy NM, Martineau PA. A new procedure for tibial spine avulsion fracture fixation. Knee Surg Sports Traumatol Arthrosc. 2012 Dec;20(12):2395-8. doi: https://doi.org/10.1007/s00167-012-1906-9. Epub 2012 Jan 24.

Kendall NS, Hsu SY, Chan KM. Fracture of the tibial spine in adults and children. A review of 31 cases. J Bone Joint Surg Br. 1992 Nov;74(6):848-52.

Lubowitz JH, Elson WS, Guttmann D. Part II: arthroscopic treatment of tibial plateau fractures: intercondylar eminence avulsion fractures. Arthroscopy. 2005 Jan;21(1):86-92.doi: https://doi.org/10.1016/j.arthro.2004.09.031.

Meyers MH, McKeever FM. Fracture of the intercondylar eminence of the tibia. J Bone Joint Surg Am. 1970 Dec;52(8):1677-84.

Zariczny jB, Avulsion fractures of the tibialeminence : treatment by open reduction and pinning. Arthrosc Tech. 2014 Dec; 3(6): e683–e687.Published online 2014 Nov 24. doi: https://doi.org/10.1016/j.eats.2014.08.008.

Rockwood CA, Wilkins KE, BeatyJH.Fractures in children. Philadelphia:Lippincott-Raven 1996 : 1296-1298.

Kocher MS, Micheli LJ, Gerbino P, Hresko MT. Tibial eminence fractures in children: prevalence of meniscal entrapment. Am J Sports Med. 2003 May-Jun;31(3):404-7.doi: https://doi.org/10.1177/03635465030310031301.

Senekovic V, Veselko M. Anterograde arthroscopic fixation of avulsion fractures of the tibial eminence with a cannulated screw: five-year results. Arthroscopy. 2003 Jan;19(1):54-61.doi: https://doi.org/10.1053/jars.2003.50012.

Kocher MS, Foreman ES, Micheli LJ. Laxity and functional outcome after arthroscopic reduction and internal fixation of displaced tibial spine fractures in children. Arthroscopy 2003;19:1085-1090.

Coyle C, Jagernauth S, Ramachandran M. Tibial eminence fractures in the paediatric population: a systematic review. J Child Orthop. 2014 Mar;8(2):149-59. doi: https://doi.org/10.1007/s11832-014-0571-6. Epub 2014 Mar 2.

McLennan JG. The role of arthroscopic surgery in the treatment of fractures of the intercondylar eminence of the tibia. J Bone Joint Surg Br. 1982;64(4):477-80.

Matthews DE, Geissler WB. Arthroscopic suture fixation of displaced tibial eminence fractures. Arthroscopy. 1994 Aug;10(4):418-23.doi: https://doi.org/10.1016/s0749-8063(05)80193-8.

Medler RG, Jansson KA. Arthroscopic treatment of fractures of the tibial spine. Arthroscopy. 1994 Jun;10(3):292-5.doi: https://doi.org/10.1016/s0749-8063(05)80114-8.

Hunter RE, Willis JA. Arthroscopic fixation of avulsion fractures of the tibial eminence: technique and outcome. Arthroscopy. 2004 Feb;20(2):113-21.doi: https://doi.org/10.1016/j.arthro.2003.11.028.

Berg EE. Comminuted tibial eminence anterior cruciate ligament avulsion fractures: failure of arthroscopic treatment. Arthroscopy. 1993;9(4):446-50.doi: https://doi.org/10.1016/s0749-8063(05)80320-2.

Montgomery KD, Cavanaugh J, Cohen S, Wickiewicz TL, Warren RF, Blevens F. Motion complications after arthroscopic repair of an¬terior cruciate ligament avulsion fractures in the adult. Arthroscopy Volume 18, Issue 2, February 2002, Pages 171–176.doi: https://doi.org/10.1053/jars.2002.30433.

Gerber C, Schneeberger AG, Beck M, Schlegel U. Mechanical strength of repairs of the rotator cuff. J Bone Joint Surg Br. 1994 May;76(3):371-80.

Arthroscopic suture fixation of comminuted tibial spine fractures-a prospective study
CITATION
DOI: 10.17511/ijmrr.2016.i07.04
Published: 2016-07-31
How to Cite
1.
Kumar S, Kushwaha SS, Singh S, kumar D, Sharma V. Arthroscopic suture fixation of comminuted tibial spine fractures-a prospective study. Int J Med Res Rev [Internet]. 2016Jul.31 [cited 2024Nov.22];4(7):1097-101. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/612
Section
Original Article