Anatomical fixation of tibial intercondylar eminence fractures in children using a threaded pin with an adjustable lock

Orthop Traumatol Surg Res. 2022 Oct;108(6):103021. doi: 10.1016/j.otsr.2021.103021. Epub 2021 Jul 24.

Abstract

Introduction: Tibial intercondylar eminence fractures are a rare pathology causing anterior laxity of the knee, which requires anatomical reduction and a stable osteosynthesis. The aim of this study was to present the clinical results of reinsertion in anatomical position of these fractures, in the paediatric population, using a threaded pin with an adjustable lock.

Hypothesis: Our hypothesis was that the clinical results would be satisfactory and comparable to the literature.

Method: This retrospective, monocentric study involved 34 consecutive patients with tibial intercondylar eminence fractures, divided into 55.9% with type 2, 35.2% with type 3, 8.8% with type 4 according to Meyers & McKeever, operated on between March 1999 and March 2018. Assessments were performed at a minimum follow-up of 1-year and included the Lysholm, subjective International Knee Documentation Committee (IKDC) and Tegner activity scores, and the measurement of anterior knee laxity by the KT1000.

Results: At the average follow-up of 8.8 years, 7 patients were lost to follow-up, 2 required anterior cruciate ligament reconstruction. Pathological residual laxity was present in 25% of cases and instability in 16%. The average Lysholm score was 93.1±9.8, the average subjective IKDC was 93.8±6.4 and the average Tegner score was 5.6±1.5. The average anterior laxity of the knee was 0.7±2.0mm.

Conclusion: The anatomical reinsertion using a threaded pin with an adjustable lock for tibial intercondylar eminence fractures in a paediatric population provides good functional results and is comparable to the data in the literature.

Level of evidence: IV; retrospective.

Keywords: Arthroscopy; Paediatrics; Tibial intercondylar eminence fracture.

MeSH terms

  • Arthroscopy / methods
  • Child
  • Humans
  • Knee Joint / surgery
  • Retrospective Studies
  • Suture Techniques
  • Tibia / surgery
  • Tibial Fractures* / surgery
  • Treatment Outcome