Efficacy of arthroscopic treatment fracture of intercondylar eminence of tibia in children

Abstract:

Objective：To retrospectively analyze the efficacy of arthroscopic treatment fracture of intercondylar eminence of tibia in children;to evaluate the difference of surgical methods and provide help for clinical treatment. Methods：Totally 42 pediatriccases of tibial intercondylar eminence fracture treated by arthroscopy or open reduction between March 2007 to September 2018 were retro－spectively analyzed. Eight patients were treated by open reduction（open reduction group），15 patients were treated with hollow screw internal fixation（hollow screw group），6 patients were treated with absorbable cartilage nail fixation（cartilage nail group），and 13 pa－tients were treated with Kirschner wire fixation（Kirschner wire group）. Long leg plaster or braces were used for fixation for 4 to 6 weeks after operation. Regular outpatient follow-up and telephone follow-up were conducted. The efficacy was evaluated according to Lysholm score，the flexion and extension of the knee，and knee stability. Results：The operation time of the arthroscopic absorbable cartilage nail group[（118.33±21.66） min] was longer than that of the Kirschner wire group[（81.54±37.78） min] and the hol－low screw group[（83.33±35.74） min]（t=2.215，P=0.041；t=2.800，P=0.013）. The operation time of arthroscopic group was （88.82±36.31） min，which was less than that of open reduc－tion group [（105.00±41.14） min]（t=－1.107，P=0.275）. The aver－age amount of bleeding in the arthroscopic operation group[（2.79±1.27） mL] was less than that in the open operation group[（9.38±1.77） mL] （t=-12.195，P=0.000）. There was no significant dif－ference in the amount of bleeding among the three different fixation methods under arthroscope（F=0.054，P=0.948）. The Lysholm score in the lastest follow-up of the arthroscopic group（97.53±3.11） was higher than that of the open group（92.00±6.97）（t=2.193，P=0.061）. There was no significant difference in Lysholm score between the arthroscopic group and the open reduction group（F=0.115，P=0.892）. All the children’s incisions were primary healing，and bony healing was achieved within 3 months. At the lastest follow-up，the anterior drawer test and Lachman test of these children were all negative. One child in Kirschner wire group had a knee stiffness，two children had knee stiffness in the open reduction group，while the others had normal mobility. Conclusion：Arthroscopy-assisted fixation with hollow screw，absorbable cartilage screw and Kirschner wire can all achieve good results in the treatment of tibial inter－condylar fractures in children. However，different internal fixation methods have their own advantages. We insist that hollow screw fix－ation for tibial Intercondylar eminence fracture in children has the advantages of simple proccedures，definite fixation，small trauma and quick recovery of the function of the knee. It’s an ideal method of treatment for the tibial intercondylar eminence fracture in children.