Fractures of the intercondylar eminence in children and adolescents

The treatment of choice of completely dislocated fractures of the intercondylar eminence is controversial. Recently, Zifko and Gaudernak [14] introduced a new classification in which they distinguish between two different types of intercondylar fractures: Type A: isolated avulsion of the anterior cruciate ligament Type B: fractures including the intercondylar eminence In order to assess whether this new classification could lead to a better selection of patients requiring open reduction, 19 children were reviewed 2-16 years after they had sustained a fracture of the intercondylar eminence. All patients with incompletely displaced fragments had an excellent or good ultimate result, independent of the kind of initial treatment received. Eleven patients sustained a complete displaced fracture. Of these, two had a poor result. Both had been treated conservatively for isolated avulsion of the anterior cruciate ligament. All conservatively treated type-B fractures had an excellent or good result. It is concluded that completely displaced type-A fractures require operative treatment by open reduction and fixation of the avulsed fragment.