Arthroscopic Three Hybrid Anchor Construct Fixation in Skeletally Immature Patients With Tibial Eminence Fractures

This article describes a surgical technique for skeletally immature patients with tibial eminence fractures of the anterior cruciate ligament (ACL) insertion. Owing to the distinct anatomical characteristics in skeletally immature patients compared with adults, we arthroscopically implanted a three hybrid anchor construct into the posterior, anteromedial, and anterolateral aspects of the fracture bed, respectively, so that the force of the downward fracture fragment was distributed in a triangular network with more uniform force. The main advantages of this method are that there is no need to drill any transphyseal bone tunnel, the anchors are implanted in the proximal tibial physis to avoid damage to the physis and ACL, and all operations are performed under arthroscopy.