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1、Arthroscopic Reduction and Internal Fixation of TibialEminence Fractures,once thought to occur only in the pediatric population,in adults as well.,Fractures of the tibial intercondylar eminence,The ability to arthroscopically 1.evaluate the fracture pattern 2.address concomitant intraarticular patho
2、logy.,Cannulated screw fixation has been shown to have good strength and fracture stabilization.,Existing problems1.smaller or comminuted fracture fragments2.The potential for hardware impingement with the subsequent loss of knee extension3.coupled with the possibility of screw removal,suture fixati
3、on is biomechanically stronger than screw fixation.,Surgical Technique,Created a central transpatellar portala superior percutaneous 4.5-mm K-wire may be used to obtain provisional fixation.,Surgical Technique,A No.5 FiberWire is then shuttled through the base of the ACL with the SutureLasso.,Surgic
4、al Technique,The ACL guide system is used to drill 2 parallel tunnels within the tibia.,Surgical Technique,unscrews and removes the inner drill bit while leaving the outer cannulated drill sleeve in place A Nitinol suture loop is then passed up through the outer cannulated drill bit into the knee.,S
5、urgical Technique,One end of the No.5 FiberWire is then shuttled by use of the Nitinol loop from the working portal down the medial tunnel and out the anterior aspect of the tibia.,Surgical Technique,The other end of the No.5 FiberWire is shuttled in the same manner out of the second drill hole.The
6、reduction is confirmed,and the suture is then tied over a bony bridge on the anteriormedial cortex of the tibia.,Discussion,Arthroscopic has advanced to become the preferred method of treatmentThe addition of the cannulated drill significantly simplifies the process of suture passage while maintaining fracture reduction and minimizing surgical steps.,Thank you for your attention,
