Journal of Musculoskeletal Trauma

Arthroscopic Treatment of The Tibial Intercondylar Eminence Fractures: Han Chul Kim, Beom Kim; J Korean Soc Fract 2000;13(3):488-493. Published online July 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.3.488

Abstract PDF: PURPOSE
To compare operative results between pull-out wiring and retrograde screw fixation for displaced tibial intercondylar eminence fracture.
MATERIALS AND METHODS
From March 1997 to February 1999, authors carried out pull-out wiring in 3 patients and retrograde screw fixation in 5 patients who sustained typeII and typeIII displaced tibial intercondylar eminence fractures follow up for 16 months(mean).
RESULTS
The Union time was mean 7 wk in pull-out wiring and 6.5 wk in retrograde screw fixation. Limitation of knee motion(1 case) developed in retrograde screw fixation group and reoperated for adhesiolysis. Pull-out wiring group were all full motion recovered. Anterior instability(1 case) developed in retrograde screw fixation group and pull-out wiring group had no instability. Operation time for retrograde screw fixation group was mean 98min and pull-out wiring group was 105 min.
CONCLUSION
The outcome of pull-out wiring group were superior to retrograde screw fixation group. It can be stably fixed and allow early motion exercise. Besides, in case of small bony fragment, it is difficult for fixation with screw. And even impossible. In child cases, the multiple percutaneous pinning can lead to good result. So authors believe that pull-out wiring is worthy for tibial intercondylar eminence fracture.

Treatment of Tibial Eminence Fracture: Taik Seon Kim, Jae Ik Shim, Sung Jong Lee, Suk Ha Lee, Dong Ki Lee, Yeon Sik Yoo, Won Gyu Yang; J Korean Soc Fract 1999;12(1):83-89. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.83

Abstract PDF: Fracture of tibial intercondylar eminence has a clinical importance in aspect of associated ligament injury, limited range of motion and joint instability The purpose of this study is to evaluate the intercondylar eminence fracture and to compare the results of treatment by method of arthroscopic reduction and pull-out suture with results of conservative treatment. The results were evaluated with Mayers and Mckeevers criteria of result and instability. 23 cases of avulsion fracture of tibial intercondylar eminence were reviewed. Most common type was type II Most common cause was traffic accident. Closed reduction and cast immobilization was performed in 12 cases, of which 10 cases had above good result initially, reduction with pull-out suture by arthroscopy was performed in 11 cases, of which 10 cases had above good refult. Type III B fracture were reduction with minimal arthrotomy because of the arthroscopic reduction was difficult. 2 cases of instability were in type III A and type III B. An instability case of type III A was treated non-operatively and the other of type III B was treated pull-out suture. 1 case of extension limitation was in type II which waf treated non-operatively because of multiple injury.

Treatment Using Arthroscopic Reduction and Fixation in Tibial Intercondylar Eminence Fracture: Chung Nam Kang, Dong Wook Kim, Sang Hoon Ko; J Korean Soc Fract 1997;10(2):356-364. Published online April 30, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.2.356

Abstract PDF: Meyers and Mckeever proposed a classification of intercondylar eminence fractures based on the degree of displacement. Zaricznyj added type IV comminuted avulsion fracture. Type III and IV of tibial spine fractures are considered an indication for surgery. The purpose of this study is to evaluate the result of arthroscopic treatment for displaced intercondylar eminence fractures. In all of the cases, the displaced fragments were reduced arthroscopically in effective, and fixed by K-wires, pull-out sutures or pull out wiring. At last follow-up above 12 months, all 22 cases(100%) were evaluated as above good by Meyers and Mckeever criteria.

Arthroscopic Assisted Management For the Fracture Of the Tibial Intercondylar eminence Using Tension Band Technique: Seung Rim Park, Hyoung Soo Kim, Joon Soon Kang, Woo Hyung Lee, Sung Eyu Lee, Hyun Yang Chun; J Korean Soc Fract 1997;10(1):67-72. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.67

Abstract PDF: Avulsion fracture of the intercondylar eminence of the tibia(Type III as classified By Meyers and Mckeever) can be managed by arthroscopic reduction and fixation. Recently, the different arthroscopic suturing techniques, fixation with K-wire, screw and staple fixation have been employed to treat this injuries, however, most of these techniques are complicated and they do not always achieve stable fixation enough to facilitate early rehabilitation and restore stability to the knee through a full range of motion so far. A new technique for treatment of the tibial spine fracture arthroscopically, using the tension band method is presented. The advantage of this method include : 1. to be technically less demanding. 2. to allow for stable fixation even thin or comminuted fragments. 3. to present simple and safe removal of internal fixation. 4. to facilitate early rehabilitation.

A Clinical Comparative Study for the Results of the Tibial Intercondylar Eminence Fracture: Hyun Kee Chung, Choong Hyeok Choi, Chang Ho Rho, Jae Lim Cho; J Korean Soc Fract 1996;9(3):656-664. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.656

Abstract PDF: The management of fractures of the tibial intercondylar eminence is uncomplicated when the fracture has minimal displacement(Type I) or when only one-third or a half of the eminence is elevated(Type II). However, the treatment of complete separation(Type III) has been controversial. Authors reviewed 35 cases in 35 patients of the tibial intercondylar eminence fracture at the Department of Orthopedic Surgery of Hanyang University Hospital from Jan. 1988 to Dec. 1994. The results were as follows: 1) There was a predisposition for male and prevalent age distribution was 2nd to 4th decade. 2) The most common cause of injury was traffic accident in 22 cases(62.9%). 3) The most common associated injury was rupture of MCL on the ipsilateral knee in 11 cases (37%). 4) According to the Meyers and Mckeevers classification, type III was most common in 24 cases(69%), type II was 7 cases(20%) and type I was 4 cases(11%). 5) The excellent or good result was 82% in conservative treatment group, 83% in screw fixation group and 92% in pull out suture group. 6) In case of small size and comminution of the fragment, it was difficult to fix the fragment with screw fixation. So, we recommend the method of fixation with pull out suture technique for small or comminuted type III fracture.

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