Part II: arthroscopic treatment of tibial plateau fractures: intercondylar eminence avulsion fractures.

Arthroscopic reduction and internal fixation (ARIF) of tibial intercondylar eminence fractures is the emerging state-of-the-art. ARIF is recommended for displaced type III fractures and should be considered for all cases of displaced type II fractures. Fractures without displacement after closed reduction require careful evaluation to rule out meniscal entrapment. Subjective results of ARIF are uniformly excellent, despite reports of objective anteroposterior laxity. Early range-of-motion exercises are essential to prevent loss of extension. Repair using nonabsorbable suture fixation, when of adequate strength to allow early range-of-motion, has the advantages of eliminating the risks of comminution of the fracture fragment, posterior neurovascular injury, and need for hardware removal, compared with ARIF using screws.

[1]  S. Falstie-Jensen,et al.  Incarceration of the meniscus in fractures of the intercondylar eminence of the tibia in children. , 1984, Injury.

[2]  J. Fulkerson,et al.  Entrapment of the medial meniscus in a fracture of the tibial eminence. , 1988, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[3]  P. Broos,et al.  Pediatric and adolescent tibial eminence fractures: arthroscopic cannulated screw fixation. , 2002, The Journal of trauma.

[4]  S. Canale,et al.  Campbell's operative orthopaedics , 1987 .

[5]  E. Wall Tibial eminence fractures in children , 1998 .

[6]  G. Hirsch,et al.  Fracture of the Anterior Tibial Spine in Children , 1984, Journal of pediatric orthopedics.

[7]  M. Rang Children's Fractures , 1983 .

[8]  D. E. Matthews,et al.  Arthroscopic suture fixation of displaced tibial eminence fractures. , 1993, Orthopedics.

[9]  E. Berg Pediatric tibial eminence fractures: arthroscopic cannulated screw fixation. , 1995, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[10]  Charles A. Rockwood,et al.  Rockwood and Green's Fractures in Adults , 1991 .

[11]  Lubowitz Jh,et al.  Arthroscopic treatment of anterior cruciate ligament avulsion. , 1993 .

[12]  J. Marsh Tibial Plateau Fractures , 1997 .

[13]  Brett D Owens,et al.  Treatment of type III tibial intercondylar eminence fractures in skeletally immature athletes. , 2003, American journal of orthopedics.

[14]  B. Koo,et al.  A new method for arthroscopic treatment of tibial eminence fractures with eyed Steinmann pins. , 1999, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[15]  R. Hunter,et al.  Arthroscopic fixation of avulsion fractures of the tibial eminence: technique and outcome. , 2004, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[16]  A. Amendola,et al.  Technique for arthroscopic suture fixation of displaced tibial intercondylar eminence fractures. , 1997, Arthroscopy: The Journal of Arthroscopy And Related.

[17]  E. Berg,et al.  Comminuted tibial eminence anterior cruciate ligament avulsion fractures: failure of arthroscopic treatment. , 1993, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[18]  B. Zaricznyj,et al.  Avulsion fracture of the tibial eminence: treatment by open reduction and pinning. , 1977, The Journal of bone and joint surgery. American volume.

[19]  J G McLennan,et al.  The role of arthroscopic surgery in the treatment of fractures of the intercondylar eminence of the tibia. , 1982, The Journal of bone and joint surgery. British volume.

[20]  R. Marti,et al.  A fracture of the intercondylar eminence of the tibia treated by arthroscopic fixation. , 1991, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[21]  J. Wiley,et al.  Tibial spine fractures in children. , 1990, Clinical orthopaedics and related research.

[22]  L. Osti,et al.  Our experience in the arthroscopic treatment of fracture-avulsion of the tibial spine. , 1997, La Chirurgia degli organi di movimento.

[23]  C. Rinaldi,et al.  [Fractures of the tibial plateau]. , 1962, Archivio "Putti" di chirurgia degli organi di movimento.

[24]  B. Zifko,et al.  [Problems in the therapy of avulsions of the intercondylar eminence in children and adolescents. Treatment results based on a new classification]. , 1984, Unfallheilkunde.

[25]  Prince Ar,et al.  Arthroscopic treatment of an avulsion fracture of the intercondylar eminence of the tibia. Case report. , 1995 .

[26]  J. T. Chandler,et al.  Tibial eminence fracture with meniscal entrapment. , 1995, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[27]  J. B. Smith Knee Instability After Fractures of the Intercondylar Eminence of the Tibia , 1984, Journal of pediatric orthopedics.

[28]  K. Terayama,et al.  Arthroscopic reduction and fixation of a completely displaced fracture of the intercondylar eminence of the tibia. , 1994, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[29]  M. Meyers,et al.  Fracture of the intercondylar eminence of the tibia. , 1959, The Journal of bone and joint surgery. American volume.

[30]  F R Noyes,et al.  Biomechanics of anterior cruciate ligament failure: an analysis of strain-rate sensitivity and mechanisms of failure in primates. , 1974, The Journal of bone and joint surgery. American volume.

[31]  Y. Oohashi,et al.  A simple technique for arthroscopic suture fixation of displaced fracture of the intercondylar eminence of the tibia using folded surgical steels. , 2001, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[32]  V. Senekovič,et al.  Anterograde arthroscopic fixation of avulsion fractures of the tibial eminence with a cannulated screw: five-year results. , 2003, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[33]  H. Klasen,et al.  Fractures of the intercondylar eminence in children and adolescents , 2004, Archives of orthopaedic and traumatic surgery.

[34]  K. Jansson,et al.  Arthroscopic treatment of fractures of the tibial spine. , 1994, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[35]  M. Kocher,et al.  Tibial Eminence Fractures in Children: Prevalence of Meniscal Entrapment , 2003, The American journal of sports medicine.

[36]  L. Osti,et al.  A simple modified arthroscopic procedure for fixation of displaced tibial eminence fractures. , 2000, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[37]  Harold G. Lee AVULSION FRACTURE OF THE TIBIAL ATTACHMENTS OF THE CRUCIAL LIGAMENTS , 1937 .

[38]  D. Yip,et al.  Modified arthroscopic suture fixation of displaced tibial eminence fractures using a suture loop transporter. , 2001, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[39]  C. Yılmaz,et al.  Arthroscopic fixation of intercondylar eminence fractures using a 4-portal technique. , 2001, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[40]  M H Reed,et al.  Fractures and dislocations of the extremities in children. , 1977, The Journal of trauma.

[41]  Closed treatment of fracture of the tibial spines. , 1974, Injury.

[42]  A. G. Pollen Fractures and dislocations in children , 1973 .

[43]  A. Freedman,et al.  The Anatomy of Tibial Eminence Fractures: Arthroscopic Observations Following Failed Closed Reduction , 2002, The Journal of bone and joint surgery. American volume.

[44]  C. Burri,et al.  Fractures of the tibial plateau. , 1979, Clinical orthopaedics and related research.