Tibial Spine Avulsion Fracture Fixation Using a Re-tensionable All-Suture Construct

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanics

Background:

• Tibial spine avulsion fractures are a subset of anterior cruciate ligament (ACL) injuries.
• Traditional treatment involved open reduction and internal fixation, with ACL reconstruction reserved for failures or persistent laxity.
• Limitations of screw fixation include hardware complications, difficulty with comminuted fractures, and physeal injury risk.

Purpose of the Study:

• To describe an arthroscopic technique for tibial spine avulsion fracture reduction and fixation.
• To detail the use of a re-tensionable all-suture construct.
• To highlight the advantages over traditional fixation methods.

Main Methods:

• Arthroscopic-assisted reduction of the tibial spine avulsion fracture.
• Internal fixation utilizing a re-tensionable all-suture construct.
• Employing multiple looped cinch stitches and a cortical suspensory suture button device.

Main Results:

• The described technique allows for minimally invasive fixation of tibial spine avulsion fractures.
• All-suture fixation overcomes limitations of traditional screw fixation.
• The re-tensionable construct offers adjustability and potentially improved stability.

Conclusions:

• Arthroscopic fixation of tibial spine avulsion fractures with all-suture constructs is a viable and advanced treatment option.
• This technique offers a solution for hardware-related complications and challenges associated with comminuted fractures.
• The use of suture button devices and cinch stitches provides a secure and adjustable fixation method.