2015 ISAKOS Biennial Congress ePoster #604
Arthroscopic Fixation for Tibial Eminence Fractures -Viewing from Proximal Superomedial Portal and Fixation with Endobutton
Takashi Fukushima, MD, Shimotsuke, Tochigi JAPAN
Hitoshi Sekiya, MD, Kawachi-Gun, Tochigi JAPAN
Hitoshi Sekiya, MD, Kawachi-Gun, Tochigi JAPAN
3311-1 Yakushiji, Shimotsukeshi, Tochigiken, JAPAN
FDA Status Not Applicable
Summary: Arthroscopic pull-out techniques for avulsion fracture of the tibial eminence are relatively complicated method, and it includes the risk of breakage of the fragment by wires or strings. We developed new technique for arthroscopic fracture fixation with Endobutton under the view from proximal superomedial portal, and we applied the technique in 6 cases. Proximal superomedial portal were suitable f
Abstract:
Introduction
Fracture of the tibial intercondylar eminence is an avulsion fracture of the anterior cruciate ligament (ACL) from its tibial insertion. The fractures with large displacement should be surgically treated. Recently, arthroscopic procedures have been getting its popularity because of its less invasiveness. In the fracture with large bony fragment, screw fixation could be applied; however, in the fracture with small or comminuted fragments, pull-out technique are selected. Arthroscopic pull-out techniques for avulsion fracture of the tibial eminence are relatively complicated method, and it includes the risk of breakage of the fragment by wires or strings.
Materials And Methods
We developed new technique for arthroscopic fracture fixation with Endobutton under the view from proximal superomedial portal, and we applied the technique in 6 cases. Proximal superomedial portal were suitable for observation of the fracture site, and also suitable for fracture reduction without the damage of intermeniscal ligament. We made one or two drill holes 2.4mm in diameter through fracture fragment and ACL fibers from anterior side of proximal tibia using ACL targeting device. Using suture relay technique, we introduced one or two Endobutton on the surface of fracture fragments through arthroscopic portal. And, Endobutton were fixed on the fragments with No.2 FiberWire by pull-out method. Due to the solid fixation of the fracture with the Endobutton, vigorous postoperative exercise could be initiated immediately after the surgery.
Results
and DISCUSSION
Average surgical time was 60 minutes. No complications occurred at perioperative periods. No limitation of range of motion and no subjective and objective instability of the knee joint were found in all case at final follow-up. Endobutton fixation by our method prevented suture cut-through unlike conventional pull-out procedures, and it allows for a large implant-bone interface, and also it offered sufficient strength of fixation to promote fracture healing.