[Multi-spot suture fixation under arthroscope for treating tibial intercondylar anterior eminence fracture]

To explore the surgical method and effectiveness of multi-spot suture fixation under arthroscope in treating tibial intercondylar anterior eminence fracture.

Between February 2006 and January 2010, 15 patients with tibial intercondylar anterior eminence fracture were treated with multi-spot suture fixation under arthroscope after fracture reduction. There were 14 males and 1 female with a median age of 33 years (range, 7-55 years). The injury causes were traffic accident in 9 cases, sport in 2 cases, and falling in 4 cases. The anterior drawer test, Lachman test, and pivot shift test in all the cases turned out to be positive. The Lysholm score was 64.7 +/- 1.3. According to Meyers-McKeever classification, 5 cases were classified as type II, 7 cases as type III, and 3 cases as type IV. Of them, 13 cases had fresh fracture and 2 cases had old fracture. Assisted with anterior cruciate ligament-aimer, bone tunnels (2 mm in diameter) were built through the fracture fragments after fracture reduction, through which Ethibond 2 polyester sutures were guided into the joint by No.18 spine needles; after knot of 2 sutures or knot of only 1 suture was made, the other ends of sutures were fastened together outside the joint.

The incisions of all the cases healed by first intention with no complication of infection or deep venous thrombosis. Fifteen patients were followed up 14-48 months with an average of 24.2 months. The X-ray examination indicated fractures healed in all the cases at 2-4 months (mean, 3 months). At 6 months after operation, 14 cases showed negative results of Lachman test and anterior drawer test but 1 case positive, while all the cases showed negative results in pivot shift test. The extension and flexion spheres of knee activity were normal in 13 cases and were limited in 2 cases. The Lysholm score was 95.1 +/- 2.1, showing significant difference when compared with the preoperative score (t = 43.020, P = 0.000).

Multi-spot suture fixation under arthroscope is an effective method with small invasion, reliable fixation, and simple operation for treating tibial intercondylar anterior eminence fracture.