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Objective:To investigate the efficacy of arthroscopic reduction and double-tunnel button fixation in the treatment of fractures of the tibial intercondylar eminence in children.Methods:From January 2019 to June 2022, 8 children with fracture of the tibial intercondylar eminence were treated at Orthopedics Department, Shenzhen Children's Hospital with arthroscopic reduction and double-tunnel button fixation. They were 6 boys and 2 girls, with an age of (8.4±1.9) years. Injured sites: 4 left knees and 4 right knees. Their operation time, intraoperative blood loss, knee flexion and extension, and complications were recorded. Their Lysholm scores were compared between preoperation and the last follow-up.Results:The operation time was (161.9±57.9)min. All patients were followed up for (12.1±5.7) months. The intraoperative blood loss was 3.5 (1.0,4.3)mL. Their knee flexion was 145.0°±5.0° and extension 0.9°±1.2° after operation. All their incisions healed at one stage, with no postoperative infection or other complications. Their preoperative Lysholm score [(20.3±15.8) points (from 2 to 54 points)] increased significantly to (99.3±1.0) points (from 98 to 100 points) after operation ( P<0.05). Conclusions:Arthroscopic reduction and double-tunnel button fixation is effective for fractures of the tibial intercondylar eminence in children, leading to limited complications, limited bleeding and a low infection rate.
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Objective To find out if there is any difference in intercondylar fossa width and notch width index (NWI) between tibial intercondylar eminence avulsion fracture and anterior cruciate ligament (ACL) injury.Methods A retrospective study was conducted of the patients who had sought medical attention at Department of Sports Medicine and Adult Reconstructive Surgery,Drum Tower Hospital from June 2014 to May 2018.There were 10 patients with tibial intercondylar eminence avulsion fracture (4 males and 6 females with an average age of 32.7 ± 9.2 years),13 patients with ACL injury (8 males and 5 females with an average age of 31.8 ± 10.9 years) and 22 patients with simple meniscus injury as controls (13 males and 9 females with an average age of 30.9 ± 10.6 years).They all had MRI examination of the knee before surgery.The width of intercondylar fossa and the width and height of bilateral femoral condyles were measured on high resolution images of MRI axial view.NWI was calculated.The 3 groups were compared in intercondylar fossa width and NWI.Results The 3 groups of patients were comparable because there were no significant differences in gender,age,height,weight or BMI between them (P ＞ 0.05).The intercondylar fossa width in the ACL injury group (17.4 ± 3.5 mm) was significantly smaller than that in the avulsion fracture group (20.8 ± 1.1 mm) or in the control group (20.2 ±2.6 mm) (P ＜ 0.05),but no significant difference was detected between the avulsion fracture group and the control group (P ＞ 0.05).NWI in the avulsion fracture group (0.301 ±0.011) was similar to that in the control group (0.280 ±0.039) (P ＞ 0.05) but significantly higher than that in the ACL injury group (0.25 ± 0.05) (P ＜ 0.05).NWI in the ACL injury group was significantly lower than that in the control group (P ＜ 0.05).Conclusions Intercondylar notch stenosis may be a risk factor for ACL injury but may not be associated with tibial intercondylar eminence avulsion fracture.The difference in pathogenesis between tibial intercondylar eminence avulsion fracture and ACL injury may be associated with their difference in NWI.
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Objective To compare the curative effect of fixation of adolescent tibial intercondylar emi-nence fracture among suture anchor,hollow screw and wire. Methods Forty-six adolescent cases of the tibial intercondylar eminence fracture treated with surgical treatment were selected from January 2010 to June 2016 and divided into three groups refer to intra-operative fixation suture anchor group(Group A),hollow screw group (Group B)and wire group(Group C).Duration of treatment,total operation time,hospital stay and surgery times were recorded. All patient condition was assessed with the Lysholm,Tegner,IKDC and VAS score. Results All patients received an average of 13(11~14)months follow-up visit. No blood-vessel,nerve and osteoepiphysis injured,infection and fracture displacement occurred.Before receiving treatment,difference in Lysholm,Tegner, IKDC and VAS score of group A,B and C showed no statistical difference.When it comes to hospitalization condi-tion,data were as follows.Group A/B/C:operation time(80.67 ± 16.68/114.00 ± 20.28/111.88 ± 20.07)min, hospital stay(8.40 ± 1.12/ 15.47 ± 1.25/ 15.19 ± 1.17)d,surgery times(1/2/2)times. Moreover,compared with those before operation and after operation in both of groups,the Lysholm,Tegner,IKDC and VAS score were improved(P < 0.05). Besides,the Lysholm,Tegner,IKDC and VAS score of group A,B and C did not have statistically significant difference yet after post treatment(P>0.05).Conclusions The curative effect of fixation of adolescent tibial intercondylar eminence fracture among suture anchor,hollow screw and wire was similar. By contrast,the fixation of fracture by use of suture anchor can decrease operation time and hospital stay to some extent. It had advantage of need not to have a second operation to remove the internal fixation and can be used in preference.