Tibial spine fractures: arthroscopic assisted reduction and percutaneous Kirschner wire fixation

ABSTRACT

The aim of this prospective study is to evaluate our results in the management of avulsion fractures of the anterior tibial spine with the aid of arthroscopy. Twelve patients with displaced tibial spine fractures with an average age of 13.3 years were the material of this study. After through clinical and radiological evaluation an operative arthroscopy for both diagnosis and treatment was done to assess and to guide both reduction and fixation with percutaneous kirschner wires. Eight added surgical techniques had required to treat the associated local knee injuries. The Lysholm scoring system was used for evaluation of the final results. Nine patients were graded as excellent, two patients as good, and one patient was graded as fair outcome. There was statistically significant correlative between the following; fracture type and positivity of anterior drawer test, age of the patients and final Lysholm scoring system, residual postoperative displacement and the final Lysholm knee scoring system, residual postoperative displacement and positive anterior drawer test was found to be statistically significant. There was no statistically significant correlative between the following; positivity of the valgus stress test and the type of the fracture, fracture type and the final Lysholm knee scoring system. Type IV fracture is the worst type regarding the incidence of associated soft tissue and bony injuries and the high rate of post-operative complications. Objective knee laxity does not always mean subjective knee laxity. The number of patients included in this study is very limited to yield a statistically significant relationship. A new comprehensive classification system is urged by this study