RESUMEN
Objective: To explore effectiveness of suture-bridge fixation under arthroscopy in treatment of tibial eminence avulsion fracture of anterior cruciate ligament in adolescents. Methods: Between June 2013 and October 2016, 18 adolescent patients suffered tibial eminence avulsion fracture of anterior cruciate ligament were treated by suture-bridge fixation under arthroscopy. There were 11 males and 7 females with an average age of 12.5 years (range, 5-17 years). The injury caused by bruise in 6 cases, by sprain in 4 cases, and by sport injury in 8 cases. The interval between injury and admission ranged from 2 hours to 10 months (mean, 2 months). The results of preoperative Lachman and anterior drawer tests were positive. There were 10 cases of knee pain, 4 cases of knee extension limitation, and 4 cases of knee extension without strength. According to the Meyer-McKeever classification criteria, 12 cases were type Ⅱ and 6 cases were type Ⅲ. Results: All incisions healed by first intention. All 18 patients were followed up 10-18 months after operation, with an average of 12 months. Postoperative X-ray films showed that all fractures healed after 6-12 weeks (mean, 8 weeks). The results of postoperative Lachman and anterior drawer tests were negative. At last follow-up, the Lysholm knee score was 90.1±5.0 and 93.1±6.2 for affected and unaffected sides, respectively, showing no significant difference between affected and unaffected sides( t=0.669, P=3.184［?］). There was no premature closure of skeleton or leg length discrepancy and deformity. Conclusion: For tibial eminence avulsion fracture of anterior cruciate ligament in adolescents, the suture-bridge fixation under arthroscopy is an effective method with many advantages, such as minimal invasion, reliable fixation, good fracture healing, and no need for second operation to remove implants.
RESUMEN
Objective To evaluate the technique and clinical effect of arthroscopic treatment of anterior cruciate ligament tibial eminence avulsion fracture with suture bridge fixation technique. Methods From May 2013 to July 2015, 18 patients with anterior cruciate ligament tibial eminence avulsion fracture were treated with arthroscopic re﹣duction and fixation by suture bridge technique. There were 12 males and 6 females with an average age of 29.8 years old (range, 9~45 years). The right knees were involved in 10 cases and left knees in 8 cases. The injury caus﹣es included traffic accident injury in 10 cases, sports injury in 5 cases and other reasons in 3 cases. 2 patients had old fracture, the others had fresh fracture. The results of Lachman and anterior drawer test were both positive. The International Knee Documentation Committee (IKDC) subject score was (53.8 ± 4.2). Based on Meyers-Mckeaver classification, there were 5 cases in typeⅡ, 10 cases in type Ⅲ and 3 cases in type Ⅳ. Results The operation time was 50~80 minutes (mean, 60.5 minutes), X-ray showed satisfactory fracture reduction after surgery. Primary healing of incision were obtained with no infection, all 18 patients were followed up for 6 ~ 31 months (mean, 18.6 months). The results of Lachman and anterior drawer test were both negative in 17 cases, the result was negative for anterior drawer test and was weakly positive for Lachamn test in 1 case. The IKDC subject score were significantly improved to (95.2 ± 3.8) at last follow-up (P< 0.05). Conclusion It could achieve early restoration of knee joint function to treat the anterior cruciate ligament tibial eminence avulsion fracture with suture bridge fixation technique because of satisfactory reduction, reliable fixation, minor trauma, and quick recovery.