Objective: To investigate the effectiveness of percutaneous reduction by leverage and fixation using nonabsorbable suture with neck wear knot loop ligature to treat tibial intercondylar eminence avulsion fractures under the arthroscope.
Methods: Between February 2003 and December 2008, 28 patients with tibial intercondylar eminence avulsion fractures were treated, including 16 left knees and 12 right knees. There were 15 males and 13 females with an average age of 19.5 years (range, 14-45 years). The injury causes included traffic accident injury in 11 cases, sport injury in 10 cases, and sprain injury in 7 cases. Based on Meyers-McKeever classification, there were 18 cases of type III and 10 cases of type IV. The X-ray films showed the tibial intercondylar eminence displaced fracture. The mean time between trauma and operation was 7 days (range, 4-12 days). All patients were treated surgically with an arthroscopically assisted reduction by leverage and fixation using 5-0 Ethibond suture with neck wear knot loop ligature.
Results: All incisions healed by first intention without infection or injuries of nerves and vessels. Twenty-eight patients were followed up 26 months on average (range, 12-66 months). The X-ray films showed fracture healing within 9-13 weeks (mean, 11 weeks). At last follow-up, all patients were able to return to their pre-injury activity and daily life. The knee joint was stable with no limp or impingement of intercondylar fossa. The knee joint range of motion was 0-130 degrees. The results of Lachman and anterior drawer tests were negative in all patients. At last follow-up, the Lysholm score was 93.5 +/- 2.5, showing significant difference when compared with the preoperative one (29.0 +/- 2.2, t = 53.000, P = 0.000).
Conclusion: Percutaneous reduction by leverage and fixation using nonabsorbable suture with neck wear knot loop ligature is minimally invasive and satisfied reduction and fixation in treating the tibial intercondylar eminence avulsion fracture under the arthroscope, so it is benefit for early functional exercises, and can achieve excellent results.