» Articles » PMID: 39443625

Arthroscopic Mini Tunnel Suture Bridge for ACL Tibial Avulsion Fractures Repair

Overview
Journal Sci Rep
Specialty Science
Date 2024 Oct 24
PMID 39443625
Authors
Affiliations
Soon will be listed here.
Abstract

The study presents an arthroscopic transosseous suture bridge technique for repairing avulsion fractures of the tibial insertion of the anterior cruciate ligament (ACL), specifically tailored for adolescent patients. The technique utilizes two mini tunnels, integrating the principles of transosseous tunneling and suture bridging to ensure stable fixation while minimizing the impact on the bone bed. Over a seven-year period, 39 patients with Meyers-Mckeever types II, III, and IV tibial avulsion fractures underwent this procedure. The surgery had an average duration of 52.7 min and resulted in decreased swelling and pain within two months postoperatively. All patients achieved full knee extension and over 120° of flexion. X-rays confirmed complete fracture healing within six to 12 months, and negative anterior drawer test and Lachman test indicated stable fixation. Significant improvements were seen in Lysholm and IKDC scores. This technique offers several advantages: it is effective, stable, and particularly suitable for adolescents due to the reduced impact on the bone bed and successful avoidance of epiphyseal plate injury.

References
1.
Eggers A, Becker C, Weimann A, Herbort M, Zantop T, Raschke M . Biomechanical evaluation of different fixation methods for tibial eminence fractures. Am J Sports Med. 2006; 35(3):404-10. DOI: 10.1177/0363546506294677. View

2.
Li J, Yu Y, Liu C, Su X, Liao W, Li Z . Arthroscopic Fixation of Tibial Eminence Fractures: A Biomechanical Comparative Study of Screw, Suture, and Suture Anchor. Arthroscopy. 2018; 34(5):1608-1616. DOI: 10.1016/j.arthro.2017.12.018. View

3.
Jang K, Bae J, Kim J, Wang J . Novel arthroscopic fixation method for anterior cruciate ligament tibial avulsion fracture with accompanying detachment of the anterior horn of the lateral meniscus: three-point suture fixation. Injury. 2013; 44(8):1028-32. DOI: 10.1016/j.injury.2012.12.008. View

4.
Hapa O, Barber F, Suner G, Ozden R, Davul S, Bozdag E . Biomechanical comparison of tibial eminence fracture fixation with high-strength suture, EndoButton, and suture anchor. Arthroscopy. 2012; 28(5):681-7. DOI: 10.1016/j.arthro.2011.10.026. View

5.
Kuang S, Su C, Zhao X, Li Y, Xiong Y, Gao S . "Figure-of-Eight" Suture-Button Technique for Fixation of Displaced Anterior Cruciate Ligament Avulsion Fracture. Orthop Surg. 2020; 12(3):802-808. PMC: 7307232. DOI: 10.1111/os.12682. View