[A study of three different procedures for avulsion fracture of tibial intercondylar eminence]

To observe the clinical outcomes and differences among three surgical procedures for avulsion fracture of tibial intercondylar eminence.

From October 1995 to October 2005, 3 different procedures had been performed on 49 patients, which included open reduction and internal fixation (Group A, n = 17), arthroscopic reduction and internal fixation( Group B, n = 19) and limited open reduction and internal fixation assisted with arthroscopy (Group C, n = 13). All patients were followed up for 1 to 10 years (average 4. 6 years).

For the 3 groups, normal extension function were 35.5%, 16.0% and 38.0%, mild abnormal 35.5%, 11.0% and 23.0%, moderate abnormal 29.0%, 47.0% and 31.0%; and severe abnormal were 0,26.0% and 8.0%. Normal flexion were 82.0%, 78.0% and 84.0%, mild abnormal 12.0%, 11.0% and 8.0%, moderate abnormal 6.0%, 11.0% and 8.0%. The positive rate of Lachman's or anterior drawer test were 35.0%, 45.0% and 38.0%; McIntoshi test were 11.0%, 16.0% and 13.0% respectively for 3 groups. Lysholm' scale were average 98.6, 97.3 and 98.2; Tegner' scale were 6.6, 6.4 and 6.7. KT-2000 showed that anterior translation of tibial were 6.9, 7.1 and 6.6 mm; side to side difference were 11.4, 1.7 and 1.5 mm, except that statistically significant differences were found in extension function between group A and group B (P = 0.02). There were no any statistically significant differences in other aspects.

Limited open and properly over reduction and three dimensional as well as strong internal fixation assisted with arthroscopy should been attempted for the treatment of avulsion fracture of tibial intercondylar eminence.