Author:
Mansour Mohammed M.,Abdeen Mohammed
Abstract
Purpose
Assessment of the short-term results of arthroscopic fixation of types II and III fractures of the tibial eminence using cannulated screws.
Type of study
This was a prospective study.
Patents and methods
A review of 16 patients with Meyers and McKeever type II or III fractures of the tibial eminence were treated with arthroscopic cannulated screw fixation at Zagazig University Hospital between May 2013 and January 2016. The International Knee Documentation Committee form, Lysholm Knee Score, and Tegner Activity scale for assessment were used for preoperative and postoperative assessments. The study group included seven men and nine women. Their average age was 25.4 years (range: 17.5–43 years). Mean follow-up time was 27 months (range: 24–32 months). The study included six type II and 10 type III fractures.
Results
At follow-up clinical examination, all the patients with types II and III lesions had a negative Lachman test result and a full range of motion, except one patient with flexion contractures (extension lag 10°). The mean Tegner score was 7 and mean Lysholm score was 96. All patients except one returned to preinjury activity levels. However, in general, the best outcomes were seen in younger patients who had significantly better scores for the International Knee Documentation Committee. In six cases, the intermeniscal ligament was interposed between the tibia and the avulsed fracture and was retracted to allow reduction of the fracture, and there were no significant differences in the outcomes of these patients.
Conclusions
Arthroscopic fixation with cannulated screws for types II and III of avulsion fractures of the tibial spine provides a satisfactory outcome. Arthroscopic treatment allows for complete inspection of the joint regarding associated injuries, fast rehabilitation, and decreased hospital stay. Moreover, fixation with cannulated screws gives firm fixation of the fragment and an early start of the range of motion.