Department of Orthopaedics, People's Liberation Army Joint Logistic Support Force 920Th Hospital, No. 212 Daguan Road, Xi Shan District, Kunming, 650032, Yunnan, China.
Kunming Medical University, Kunming, 650032, Yunnan, China.
J Orthop Surg Res. 2022 Jun 25;17(1):327. doi: 10.1186/s13018-022-03219-w.
Avulsion fracture of the tibial intercondylar eminence is a rare injury, which mainly occurs in adolescents aged 8-14 years and in those with immature bones. The current commonly used surgery may result in severe surgical trauma, affecting knee joint function and accompanied by serious complications. In this study, we described an all-inside and all-epiphyseal arthroscopic suture fixation technique for a patient to treat tibial intercondylar eminence fracture.
ETHIBOND EXCEL-coated braided polyester sutures were used for fixation. Three ETHIBOND sutures were passed through the ACL at 2, 6 and 10 o'clock of the footprint of the ACL and made a cinch-knot loop separately. Under the guidance of ACL tibial locator, three corresponding tibial tunnels were drilled with K-wires at 2, 6 and 10 o'clock of the fracture bed, and the two ends of the suture were pulled out through the tunnel with double-folded steel wire heads. After reduction of the tibial eminence, three sutures were tightened and tied to the medial aspect of the tibial tubercle.
After all the surgical treatments surgically performed by this method and following a standard postoperative protocol, our patient's ROM, stability, and functional structural scores all improved significantly.
This three-point suture technique provides a suitable reduction and stable fixation and is suitable for patients with all types of avulsion fractures of the tibial intercondylar eminence.
胫骨髁间隆突撕脱骨折是一种罕见的损伤，主要发生在 8-14 岁青少年和骨骼未成熟的人群中。目前常用的手术方法可能会造成严重的手术创伤，影响膝关节功能，并伴有严重的并发症。在本研究中，我们描述了一种全内和全骺关节镜下缝合固定技术，用于治疗胫骨髁间隆突骨折。
采用 ETHIBOND EXCEL 涂层编织聚酯缝线固定。三根 ETHIBOND 缝线分别穿过 ACL 在 ACL 足印的 2、6 和 10 点钟位置，并分别打紧结环。在 ACL 胫骨定位器的引导下，在骨折床的 2、6 和 10 点钟位置用 K 线钻三个相应的胫骨隧道，并用双折钢丝头将缝线的两端从隧道中拉出。胫骨隆突复位后，将三根缝线收紧并系于胫骨结节内侧。
所有手术均按此方法进行，并遵循标准的术后方案，患者的 ROM、稳定性和功能结构评分均显著提高。
三点缝线技术可提供合适的复位和稳定固定，适用于各种类型的胫骨髁间隆突撕脱骨折。
