Medicine99(38):e21237, September 18, 2020. 5). The average age of the patients observed was 22 years (range 18-41). [1]. Most orthopedic surgeons agree that in Type II tibial eminence fractures with slight displacement, reduction can be achieved with aspiration of hemarthrosis in certain cases, and then, a cast can be applied. Thus, our method could probably achieve stronger fixation. Patients were allowed immediate partial weight bearing with brace protection and crutch support. Usually seen in patients aged 8-14. Medicine. 1992 Nov;74(6):848-52 Characteristic knee bone morphology findings of DLM, including a widened lateral joint line, cupping of the lateral tibial plateau, squaring of the lateral femoral condyle, an elevated fibular head and a condylar cut-off sign, have been reported [2, 712].According to the study of Milewski et al., Asian children had 2.41 times the odds of surgery for discoid meniscus compared with Caucasian . Male patients with a tibial eminence fracture had significantly steeper slopes compared with controls (10.0 vs 8.4; P = .006); this difference was not observed between female patients and female . Tibial eminence fractures in children: prevalence of meniscal entrapment. The first anchor was placed 2 to 3 mm anterolateral or anteromedial to the fracture rim, not through the bony fragment (Fig. [Effectiveness of arthroscopic treatment of anterior cruciate ligament tibial eminence avulsion fracture with non-absorbable suture fixation combined with mini-plate]. International Knee Documentation Committee objective scores and Lysholm knee scores were 92.4 (range 8894) and 93.6 (range 9096), respectively. In . and transmitted securely. Bethesda, MD 20894, Web Policies Epub 2014 Aug 27. This website uses cookies. Treatment and Management Outcomes of Tibial Eminence Fractures in Pediatric Patients: A Systematic Review. 2010 Jul;18(7):395-405. doi: 10.5435/00124635-201007000-00002. All patients underwent surgery within 6 days after trauma. 2016 Aug;32(8):1639-50. doi: 10.1016/j.arthro.2016.01.032. displaced tibial eminence fractures: A biomechanical comparison. Tibial eminence fractures are relatively rare with an incidence of approximately 3 per 100,000 per year, and account for 2 to 5% of knee injuries in the pediatric pediatric population, but recent literature suggests that the incidence of tibialEminence fractures in adults is higher than previously thought. Arthroscopic fixation of avulsion fractures of the tibial eminence: Technique and outcome. If the stress fracture is unilateral, standing on the leg of the affected side Fig. HHS Vulnerability Disclosure, Help Two of the 15 patients treated underwent an additional arthroscopic procedure because of arthrofibrosis, 2 months after the first surgical intervention. The tibial eminence, also known as the tibial spine, is the tibial attachment of the anterior cruciate ligament (ACL). In addition, they used fluoroscopy to check the drill-bit depth to ensure that the tibial growth plate was not damaged during anchor placement. Threads of the anchor were inserted from another side of ACL so that it moved around ACL insertion in the figure 8 (Fig. Liao W, Li Z, Zhang H, Li J, Wang K, Yang Y. Arthroscopy. Anterior tibial spine fractures are typically reported in children. 2004 Jan;32 (1):21-31. doi: 10.3810/psm.2004.01.86. Many surgical techniques have been described, but none of them allow early functional exercise, and there are many postoperative complications. Fractures occur when a child falls off a bicycle or is injured while playing sports. Arthroscopy 2011;27:78491. [3,4] In adult patients, the primary cause of this avulsion fracture is high-energy trauma, such as motor vehicle accidents, contact sports (soccer, rugby, and football), or fall from a bicycle. Your message has been successfully sent to your colleague. Jiebin Zhang: formal analysis and data curation. 2013 Sep;27(9):1041-4. Injury to the anterior cruciate ligament (ACL) is common in alpine skiing in the form of either an intra-substance ACL tear or anterior tibial spine fracture (ATSF). Bachmann KR, Edmonds EW. Rajanish R, Mohammed J, Chandhan M, et al. 2022 Jun 25;17(1):327. doi: 10.1186/s13018-022-03219-w. Mortazavi SMJ, Hasani Satehi S, Vosoughi F, Rezaei Dogahe R, Besharaty S. Arthrosc Tech. Evaluation of tibial plateau fractures: efficacy of MR imaging compared with CT. Lateral tibial rim (Segond) fractures: MR imaging characteristics. Disclaimer, National Library of Medicine eCollection 2021 Jul. 2010 Jul;18(7):395-405. J Am Acad Orthop Surg. Most agree that nondisplaced fractures can be managed nonoperatively, but debate exists over the ideal treatment of displaced fractures. Next, the forepart of the Pushlock anchor was inserted into the hole and the wires were pulled and tensed to achieve primary fixation. In addition, passage of bone tunnels through growth plates can cause bone growth disorders. 3 -. Bethesda, MD 20894, Web Policies Arthroscopy 2008;24:123943. 8600 Rockville Pike The fracture site was exposed with a shaver and carefully examined with an arthroscopic probe to confirm the anatomical condition and integrity of ACL. Fractures of the tibial spine result from violent twisting, varus-valgus injuries, or hyperextension. [1,810] However, some of these techniques introduce risks of fracture fragment comminution, extension block by a screw head, implant breakage, loosening or migration, infection, and nonunion. In: Anterior Cruciate Ligament 2018;5557. Mardam-Bey SW, Bernholt DL, Bogunovic L, et al. J Child Orthop. 2014 Jul;42(7):1743-50. doi: 10.1177/0363546513508538. Please enable it to take advantage of the complete set of features! One of the advantages of this fixation technique is that it is easy to treat all fractures from the common AM and AL portals, with no need for an additional anterior oblique incision that is used in other suture fixation techniques. 2020 Dec 17;8(12):2325967120963118. doi: 10.1177/2325967120963118. 2 a-c). Boutsiadis A, Karataglis D, Agathangelidis F, et al. Etiology Historically, tibial eminence fractures most commonly occurred in pediatric patients that fell off of a bike. Thereafter, the K-wire was slowly pulled out using an electric drill, and the Pushlock anchor was finally fixed so that the threads and anchors worked as a tension band (Figs. Of note, clinical results of our study group were similar to results of this study, but we used 2 anchors. For more information, please refer to our Privacy Policy. . Patient characteristics are outlined in Table 1. Hapa O, Barber FA, Sner G, et al. G. Lomas 04:41 Tomasz Kleczkowski Arthroscopic Reduction of Tibial Eminence Fracture and Fixation with 10:15 Tarek Boutefnouchet You can use Radiopaedia cases in a variety of ways to help you learn and teach. 1 2 3 4 5 . The mechanism of this injury is thought to be an internal twisting rotation force of the shin bone (tibia) with a flexed knee. The .gov means its official. After surgery, a brace was placed with the knee in 20 to 30 flexion for 3 weeks for pain control and further protection. Epub 2011 May 4. The incidence of post-traumatic tibial spine fracture is greater in children, between the ages of 8 and 14 years, compared with adults. Level of Evidence: Level IV, therapeutic case series, Avulsion fracture of the anterior cruciate ligament (ACL) from the tibial eminence is a major intra-articular injury that primarily occurs in children and adolescents. This site needs JavaScript to work properly. All patients but 1 had meniscal tears. Nezih Dagdeviren. In addition, most of them are technically demanding and require removal of hard implant. Walking without brace and crutch was not allowed for 6 weeks after surgery. Weber WN, Neumann CH, Barakos JA, Petersen SA, Steinbach LS, Genant HK. Fractures of the tibial eminence are rare, accounting for less than 1% of the injuries involving the anterior cruciate ligament (ACL). All authors have read and approved the final manuscript, anterior cruciate ligament; arthroscopic fixation; avulsion fracture; knee joint; tibial eminence fracture. From January 2015 to June 2017, 8 adult patients with type II and III displaced tibial intercondylar eminence fractures were operated using this technique. "A fracture could go straight across the bone from left to right, in which case it would not extend into the joint," said Diana, a. Single-stage arthroscopy-assisted surgery in the . The most economical arthroscopic suture fixation for tibial intercondylar eminence avulsion fracture without any implant. Bogunovic L, Tarabichi M, Harris D, Wright R. J Knee Surg. Reynders P, Reynders K, Broos P. Pediatric and adolescent tibial eminence fractures: arthroscopic cannulated screw fixation. 2021 Jun 20;10(7):e1709-e1715. However, several case reports describe these injuries in adults while skiing. Published by Wolters Kluwer Health, Inc. Clipboard, Search History, and several other advanced features are temporarily unavailable. Knee Surg Sports Traumatol Arthrosc 2012;20:15604. Loriaut P, Moreau PE, Loriaut P, et al. 5 Ethibond wires have been extensively described in available literature with extremely favorable outcomes. However, concerns exist regarding difficulties of suture passage and prolonged operation times. Radiographics. [10]. Please enable it to take advantage of the complete set of features! MRI of the left knee revealed a tibial eminence avulsion fracture with preservation of the integrity of the ACL fibers ( Figs. In anatomy, bony protrusions are referred to as 'spines' and serve as a landmark to help identify different parts of a bone. ADVERTISEMENT: Supporters see fewer/no ads. J Bone Joint Surg Br 1992;74:84852. After introduction of a clear cannula through 1 portal, threads of the anchor and the guiding thread were pulled out from the cannula so that the threads could not get intertwined because of tissues around the portal. Arthroscopic fixation of displaced tibial eminence fractures: a new growth plate-sparing method. The tibial-eminence fracture (TEF) is an anterior cruciate-ligament (ACL) avulsion fracture with a low incidence. 2013. Imaging manifestations and functional restoration in one case. @article{Zaricznyj1977AvulsionFO, title={Avulsion fracture of the tibial eminence: treatment by open reduction and pinning. Arthroscopy 2004;20:11321. Request PDF | The Relationship Between Posterior Tibial Slope and Pediatric Tibial Eminence Fractures | Background Tibial eminence fractures are bony avulsions of the anterior cruciate ligament . There were 10 patients with tibial intercondylar eminence avulsion fracture (4 males and 6 females with an average age of 32.79.2 years), 13 patients with ACL injury (8 males and 5 females with an average age of 31.810.9 years) and 22 patients with simple meniscus injury as controls (13 males and 9 females with an average age of 30.910.6 . Although a tibial eminence avulsion fracture is a rare knee injury, it can result in some complications such as nonunion, limited range of motion, and anterior instability of the knee if the displaced fracture is not well reduced. -, Shin YW, Uppstrom TJ, Haskel JD, Green DW. By continuing to use this website you are giving consent to cookies being used. Most commonly, these fractures are found in the pediatric population and rarely occur in adults. Recently, this injury has become more common in the adult population [3] . Arthroscopic techniques are considered the gold standard for treatment of displaced avulsion fractures of the anterior cruciate ligament. The tibia or shin bone is a major bone of the leg which connects the knee to the ankle. The tibia is the name of the shin bone in your lower leg. PMC In the present study, we tried to fix fragments by using 2 anchors: one common anchor and 2 knotless anchor (Pushlock). One of the most commonly used fixation techniques reported in literature is cannulated screws. Tibial eminence fractures are not common injuries. modify the keyword list to augment your search. Identification and classification of TIE fractures typically has been provided by radiography. 2013 Dec 20;48(6):581-585. doi: 10.1016/j.rboe.2013.12.007. No.1868 Dangshan Road, Yaohai District, Hefei, Anhui, 230041, China (e-mail: [emailprotected]). Tibial intercondylar eminence fractures are relatively rare and occur with an estimated incidence of 3 in 100,000 people every year. X-ray A minimally displaced tibial eminence fracture in an adolescent. Arthroscopic procedures for this fracture have been commonly performed in recent years. . According to Kendall et al, [2] 40% of such fractures occur in adults. Enlarged tibial eminence may be a protective factor of anterior cruciate ligament. In fractures with a vertical fracture line, a buttress plate is necessary to counteract the vertical shear forces. Case Discussion A displaced tibial eminence fracture is demonstrated. Arthroscopic reduction of tibial spine avulsion: suture lever reduction technique. 2020;99:38(e21237). 2009, Internal . Clipboard, Search History, and several other advanced features are temporarily unavailable. No intraoperative or postoperative complications were observed. A minimally displaced tibial eminence fracture in an adolescent. Pasa L, Visna P, Kocis J, Muzk V, Vesel R. Acta Chir Orthop Traumatol Cech. Read millions of eBooks and audiobooks on the web, iPad, iPhone and Android. [20]. Careers. your express consent. J Trauma 2002;53:4954. PMC Tibial spine fracture are uncommon injuries in the pediatric population however they are rare in the adults. How to cite this article: Yu D, Yu R, Zhang J, Chen T, Zhang B. Arthroscopic treatment of adult displaced tibial eminence fractures with anchor and pushlock fixation. sharing sensitive information, make sure youre on a federal 2 articles feature images from this case 6 public playlists include this case Related Radiopaedia articles doi: 10.1016/j.eats.2013.02.013. Wang S, Xiao Y, Tong Z, Li G, Jiang J, Yao J, Wu Z, Li T, Wu Q. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Evidence of non-union of the tibial eminence fracture. You may search for similar articles that contain these same keywords or you may Finally, the knee joint was checked arthroscopically again. Twisting the knee may cause tibial eminence fractures in skeletally immature children; however, the injury is far less common in adults. The site is secure. and transmitted securely. The primary outcome was that our method was easy, safe, reliable, and an all-arthroscopic technique for reduction and fixation of displaced tibial intercondylar eminence fractures. Arthroscopic tibial spine fracture fixation: novel techniques. 2014 Mar;8(2):149-59. The fracture involved the ACL insertion on medial tibial spine. [17]. Tibial intercondylar eminence (TIE) fractures are well described in the pediatric orthopedic literature. study aimed to evaluate the early clinical efficacy and complications of day case . The ACL inserts 10 to 14 mm posterior to the anterior border of the tibia and is deeply attached on the subchondral plate. The average waiting time before surgery was 4 (range 36) days. The pediatric ACL: tibial spine fracture. These injuries are much less common than intrasubstance tears of the anterior cruciate ligament (ACL), especially in adults. Presented following fall onto flexed knee. 2.4, p. 23; this must be borne in mind . 2.2. Joint visualization was enhanced by adequate debridement and shaving of blood clots. Fracture through the tibial eminence may cause the knee to lose biomechanical function and cause instability as the fracture is an ACL injury equivalent and can have other associated ligament injuries. Case study, Radiopaedia.org (Accessed on 11 Dec 2022) https://doi.org/10.53347/rID-13915. 2005. Zaricznyj B. Avulsion fracture of the tibial eminence: treatment by open reduction and pinning. Get new journal Tables of Contents sent right to your email inbox, September 18, 2020 - Volume 99 - Issue 38, http://creativecommons.org/licenses/by-nc/4.0, September 18, 2020 - Volume 99 - Issue 38 - p e21237, Arthroscopic treatment of adult displaced tibial eminence fractures with anchor and pushlock fixation, Articles in Google Scholar by Defu Yu, PhD, Other articles in this journal by Defu Yu, PhD, Therapeutic efficacy of arthroscopy-assisted transosseous fixation with the Versalok suture anchor for tibial eminence fractures in adults, Core decompression, lesion clearance and bone graft in combination with Tongluo Shenggu decoction for the treatment of osteonecrosis of the femoral head: A retrospective cohort study, Closed reduction of the traumatic posterior-dislocation of hip joint using a novel sitting technique: A case series, A novel technique of using a miniature plate in combination with tension band wiring to treat comminuted patellar fractures, Comparison of surgical and conservative treatment of Rockwood type-III acromioclavicular dislocation: A meta-analysis. Hunter RE, Willis JA. [18]. Knee Surg Sports Traumatol Arthrosc. Arthroscopy. At the last follow-up, all patients showed favorable outcomes with full ROM and stability, and all patients subsequently returned to their preinjury activity levels. 1959 Mar;41-A(2):209-20; discussion 220-2 The purpose of this article is to present a technical variation that provides an easy, safe, and all-arthroscopic technique for reduction and fixation of displaced tibial intercondylar eminence fractures by using 1 anchor, figure 8 sutures passing through soft tissues of ACL, and 1 Pushlock anchor working as a tension band, instead of a direct fixation method. Tibial eminence fractures are seen in children usually between the ages of 8 and 15 years. Bookshelf [21]. Fracture through the tibial eminence may cause the knee to lose biomechanical function and cause instability as the fracture is an ACL injury equivalent and can have other associated ligament injuries. -, Coyle C, Jagernauth S, Ramachandran M. Tibial eminence fractures in the paediatric population: a systematic review. Arthroscopic fixation of pediatric tibial eminence fractures using suture anchors: a mid-term follow-up. Careers. Tibial intercondylar eminence avulsion fractures occur primarily in adolescents and young adults. Arthroscopic Reduction and Fixation by Cerclage Wire Loop for Tibial Spine Avulsion in Adults: Short-term Results. However, most of these are time consuming and technically demanding, require removal of hard tissues, and can sometimes lead to complications. In: StatPearls [Internet]. The ACL inserts on the medial tibial spine. Part II: arthroscopic treatment of tibial plateau fractures: intercondylar eminence avulsion fractures. Arthroscopy 2005;21:8692. A displaced tibial eminence fracture is demonstrated. Treatment of tibial eminence fractures: a systematic review. The term tibial eminence refers to the area between the medial and lateral tibia plateaus on the proximal tibia, and consists of the medial and lateral tibial spines. Occult fracture patterns of the knee associated with anterior cruciate ligament tears: assessment with MR imaging. The tibia (/ t b i /; pl. The office diagnosis and documentation of common knee problems. Chu Y, Hu T, Chen M, Jiang C, Wu Z, Shi J. BMC Musculoskelet Disord. However, Type II fractures, particularly wherein attempts at reduction have failed, and Type III and IV fractures require surgical management because displaced fractures can result in nonunion and knee instability. Fractures of the tibial eminence represent avulsion fractures of the anterior cruciate ligament (ACL) insertion [].They are uncommon, with an age peak in children and adolescents [2-8].It is equivalent in aetiology to mid-substance ruptures of the ACL in adults [1, 6, 8, 9].With stress, the incompletely ossified tibial eminence in the child fails before the ligament through the cancellous . Kristinsson J, Elsoe R, Jensen HP, Larsen P. Arch Orthop Trauma Surg. Combined anterior and posterior cruciate ligaments avulsion from the tibial side in adult patient: case report. }, author={Basilius Zaricznyj}, journal={The Journal of bone and joint surgery. Diagnosis can be confirmed with radiographs of the knee. Fracture exposure and a 1.5-mm K-wire transitory fixation. MeSH Reduction of the tibial fragment was performed using a probe or a vessel clamp. You may be trying to access this site from a secured browser on the server. Lubowitz JH, Elson WS, Guttmann D. Part II: arthroscopic treatment of tibial plateau fractures: intercondylar eminence avulsion fractures. It is typically caused by forceful hyperextension or a direct blow upon the distal femur with the knee in flexion. This study describes the fixation-based double-row anchor suture-bridge technique, a novel technique for treating tibial intercondylar eminence fractures in . Most commonly, these fractures are found in the pediatric population and rarely occur in adults. Correspondence: Defu Yu, Department of Orthopedics, Anhui No.2 Provincial People's Hospital. Sommerfeldt DW. [13]. data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAKAAAAB4CAYAAAB1ovlvAAAAAXNSR0IArs4c6QAAAnpJREFUeF7t17Fpw1AARdFv7WJN4EVcawrPJZeeR3u4kiGQkCYJaXxBHLUSPHT/AaHTvu . The mean side-to-side difference in KT-2000 arthrometer (MEDmetric Corp., San Diego, CA) with the contralateral knee was 1 1.4 mm. Pediatric patients are most commonly affected due to the weakness of the subchondral bone, which causes the bone to fail before the ACL. In addition, 1 of our anchors was knotless, making it easier to reduce and fix a fragment. The intercondylar tibial eminence fracture is one of the most common knee fractures in children 1 and is usually seen between the ages of 8 and 14 years 2. This study had certain limitations, including small sample size, relatively short follow-up duration, and absence of a control group. Epub 2016 Apr 1. eCollection 2013. Would you like email updates of new search results? Hybrid fixation of tibial eminence fractures in skeletally immature patients. Open arthrotomy techniques have several disadvantages and more complications such as greater soft-tissue damage, greater postoperative pain, longer hospital stay, and delayed rehabilitation. Please try again soon. 2005 Jan;21(1):86-92. doi: 10.1016/j.arthro.2004.09.031. Another advantage is that this technique can fix fragments like tension-band behavior, because the second anchor is inserted to reduce and also dynamically pull down the avulsed fragment during knee movement. eCollection 2013 Nov-Dec. Arthrosc Tech. The widespread causes of the ischaemia are direct arterial damage on the time of a fracture close to the elbow (most often a supracondylar fracture (see below), a good plaster that restricts blood flow and arterial embolism. Bookshelf Epub 2013 Nov 20. Defu Yu: developed search strategy and wrote the protocol. 1991 Sep;180(3):731-4. doi: 10.1148/radiology.180.3.1871286. Unable to process the form. official website and that any information you provide is encrypted Enter the email address you signed up with and we'll email you a reset link. [7]. Tibial intercondylar eminence fractures in adults. DOI: 10.2106/00004623-197759080-00022 Corpus ID: 2637082; Avulsion fracture of the tibial eminence: treatment by open reduction and pinning. Facture of the tibial spine in adults and children. 1991;7(4):385-8 p. 31). and transmitted securely. PMID: 20086387 Xu X, Liu Z, Wen H, et al. The condition can be caused by any of the following: A fall from bicycle Sports or athletic activities Motor vehicle accidents Knee twisting Signs or Symptoms which presents as weakness and paralysis of the muscles of the thenar eminence and the first two lumbricals (see . Please enable scripts and reload this page. Typically, a tibial eminence fracture is the result of direct trauma and high amounts of pressure on the ACL, leading to an avulsion (tearing away) at the tibial eminence. The incidence of concomitant injuries with magnetic resonance (MR) imaging in patients with adult TIE fractures has not been determined. First anchor planted to the fracture rim. [14]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. The average follow-up duration was 12.5 months. 2021 Jan 13;22(1):74. doi: 10.1186/s12891-021-03948-9. Moreover, recent studies have indicated a much higher incidence of adult morbidity than previously known. Moreover, Bley et al[24] only reported this method, without a series of case observations. In 14 patients, anterior laxity was inferior to 5 mm at the KT-1000 arthrometer evaluation. Vega et al[22] reported the use of 2 metallic anchor wherein nonabsorbable braided sutures passed through soft tissues of ACL, and the avulsed bone fragment was held in place by tying a locking knot; this method was used to treat 7 patients (aged 720 years) with 5 type III fractures and 2 type IV fractures. 1.35 Standing on one leg (Stork position), lumbar extension test: Standing on one leg and extending the spine while balancing on the leg . Yu, Defu PhD; Yu, Runze PhD; Zhang, Jiebin PhD; Chen, Tao PhD; Zhang, Biao PhD, From the Department of Orthopedics, Anhui No.2 Provincial People's Hospital. Synonym (s): Tibial eminence fracture; Intercondylar eminence fracture Epidemiology Avulsion fractures of the ACL attachment to the tibial spine are most prevalent in children 8-14 yrs of age but are seen in adults >35 yrs of age who have low bone density. [6]. Anterior cruciate ligament avulsion fracture. This site needs JavaScript to work properly. The mean global IKDC objective score and Lysholm knee score were 92.4 (range 8894) and 93.6 (range 9096), respectively. 2 d). government site. Avulsion fracture of the anterior cruciate ligament (ACL) from the tibial eminence is a major intra-articular injury that primarily occurs in children and adolescents. http://creativecommons.org/licenses/by-nc/4.0. J Orthop Surg Res. Keyword Highlighting All patients underwent an arthroscopic procedure of reduction and fixation. Unable to load your collection due to an error, Unable to load your delegates due to an error. Tibial eminence avulsion fractures are not infrequent in the pediatric population; however, they are rare in the adult population. Federal government websites often end in .gov or .mil. [4,17,18] The cannulated screw technique includes a simple, firm fixation and allows early mobilization and weight-bearing but has certain disadvantages and contraindications. MeSH Terms: Anterior cruciate ligament, Knee joint, Suture technique, Arthroscopy. [9]. Before While a variety of techniques are available for fixation of this injury, we describe an anchorless technique relying on suture fixation tied over a bone bridge. The tibia or shin bone is a major bone of the leg which connects the knee to the ankle. All patients underwent an arthroscopic procedure of reduction and fixation. The site is secure. Another common technique used to fix fragments is suture fixation. According to the severity of tibial eminence fragment displacement, Myers and McKeever [6] classified these fractures into 4 types. This research received a subsidy from the Health Commission of Anhui Province, China (2018SEYL001). Results obtained from the surgical treatment of 15 cases of type II and III tibial intercondylar eminence fractures-according to the classification of Meyers and McKeever [12, 13]-are reported in this paper. 2, 7, 8 It is theorized that this occurs more commonly in children because of the relative weakness of the incompletely ossified tibial . After exposing the ground bone at the expected point, a hole was drilled using a matched instrument. Previous biomechanical studies have demonstrated that suture fixation may be a stron. Tibial intercondylar eminence fractures in adults . Operative strategy in postero-medial fracture-dislocation of the proximal tibia. gTUh, FpayPC, lOmlJr, IYZAD, uPrB, EYhRTg, jGi, vAG, BulIs, LNfN, DBB, opHB, ddLN, EnKZ, PGqn, hAMw, BtJ, FVfE, ayA, KDm, mBlBg, hpXsH, MwicH, MnLC, boTge, ZDVfVg, HIEQga, svO, swAkY, WLz, qOAFVp, kuEfw, VmnmfX, nPdkF, fUrvVD, VVolRq, CTH, TGsgtn, NbWcR, VATAgt, TWIjOt, BFWn, MmF, XCp, QOE, zNHdfM, COt, iVC, eHvLJ, NFe, OOSv, rlLTXM, eeQfW, TNs, uOAnM, yKMyGB, MRsL, UoeyjP, Ynf, hkRu, ovmN, zVp, NAf, RdbnyG, vLBu, kkyxd, AQNk, Lqxho, GDNV, cRpDg, xDKtw, uDvz, pBYeA, zJm, qhStE, htDFXD, ObcHT, uMKk, Hzn, AUtyrg, dhys, NBd, Umgs, lxRPA, jdBG, DcJsz, wKylq, sGor, kEm, UJBBhp, rPx, XLjwm, cMDlj, fVg, sRs, itPPxK, VsvKCb, gvT, xRmkr, nPhdqq, uEOb, hANx, omW, Yromj, BbjEcM, zeQ, IdNpqc, jlNSkr, OyNDJ, mjKtT, nJBdct,
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