Fractures of the intercondylar tibial eminence

Fractures of the intercondylar tibial eminence are produced by a mechanism similar to that of rupture of the cruciate ligaments, in particular excessive internal rotation in varus and external rotation in valgus. When combined with other types of force there may be associated lesions of other structures, which naturally complicates the treatment and prognosis. Screw fixation is not considered satisfactory, both because of its difficulty when the posterior tuberosity is involved, the need for a second operation to remove the screw, the frequency with which the fragments break during or after the application of the screw, and the possibility that the screws may loosen. Fixation is performed by means of a metal wire transfixing the fracture, passed through two tunnels in the tibia, and anchored on the anterior surface of the tibia over a small metal plate, in order to prevent cutting through the bone under tension. It is important that the two small tunnels drilled in the tibia should exactly meet the fracture line.