| Objective:This study examines the treatments of tibial eminence fractures using various kinds of reduction and internal fixation by arthroscopy and compare the advantages and disadvantages of these fixations,and choose a suitable fixation for the tibial eminence fractures.Methods: Since April 2005~October 2009 in our hospital 138 patients (128knees) underwent arthroscopic reduction and internal fixation of tibial intercondylar eminence fracture. And all the patiens allowed a follow-up visit, including 88 male patients and 50 female patients with an average age of 25.7(from 9 to 43).In the surgery doctors fixed the fractures using medical sutures from Ethicon company for 30 knees,medical wire from our hospital for 38 knees, cannulated screw with washer from AO medical device company for 38 knees,absorbable screw from Finland for 32 knees. After surgery the average follow-up visit time is 24.4 months (from 3 months to 58 months) . Were observed before and after knee surgery X-ray, knee stability (Lachman test and ADT), knee activity, evaluation of knee function (Lysholm score).Results: All patients without wounds, joint infections, no skin necrosis or delayed healing incision.(1)Operation time: A group of 40-48 minutes, on average 45 minutes; B group 40-50 minutes, an average of 46 minutes; C Group:45-55 minutes, an average of 50 minutes; D Group :50-60 minutes, an average of 55 minutes. (2) length of hospital stay: A group of 8-12 days, an average of 10 days; B Group :10-20 days, an average of 15 days; C group; 10-24 days; D Group :10-14 days, an average of 12 days. (3) anatomic situation: A group: 20 cases; B group of 48 patients; C group: 32 cases; D group: 24 cases; anatomical reduction rate of 100%.healing time: A group :3.0-4.0 months, an average of 3.5 months; B group of 2.5-3.5 months, an average of 3 months; C group of 2.0-4.0 months, an average of 3.0 months; D Group 2.5-3.5 months, an average of 3.0 months. (5) knee stability, Lachman test, anterior drawer test and pivot shift test to evaluate postoperative stability of the knee after surgery."+",slight postive Lahaman (anterior drawer test at 20 degrees);"++",positive anterior drawer test at 90 degrees with a firm endpoint; and "+++", unrestrained positive anterior drawer test with a positive pivot shift.A group of "+" 1 case ;"++"2 cases ; B group "+ " 1 case ;"++"1 case;"+++" no; C No; D "+ "1 case ;"++"1 case.(6)knee activity: after 3 months of knee flexion and extension functions, A Group: flexion greater than 90o, 30 cases; fully extended; B group: flexion greater than 90o, 37 cases, 1 case no more than 90o;fully extended; C Group: flexion greater than 90o, 38 cases; fully extended; D Group: flexion greater than 90o, 32 cases;fully extended. (7) after 3 months Lysholm score, A group: 87.51±3.38; B group: 88.10±3.30; C group: 88.48±2.71; D group: 88.28±3.04;after 6 months Lysholm score, A group: 93.47±3.98; B group: 92.92±3.95; C group: 93.21±3.73; D group: 93.75±3.84. All patients feel well after the surgery.Conclusion: Different fixations for fractures of the tibial eminence can obtain satisfactory results, the choice of fixation should be based on age, fracture type, features of internal fixation and habits of the surgeon. |
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