Arthroscopy high-strength suture fixation in the treatment of tibial spine avulsion fractures in children and adolescents

ZHANG Hao-kai; ZHU Dan-jiang; WANG Qiang; SONG Bao-jian; FENG Wei; WEN Yu-wei

doi:10.3969/j.issn.2095-252X.2025.01.010

Abstract：Objective To explore the clinical efficacy of arthroscopic high-strength suture fixation in the treatment of tibial eminence fractures in children. Methods A retrospective analysis was conducted on 11 pediatric patients with tibial eminence fractures treated at our hospital from January 2020 to December 2022. There were 6 males and 5 females,aged 8 to 14 years (mean:9 years). Fractures involved the left side in 5 cases and the right side in 6 cases. According to the Meyers-McKeever classification,there were 5 type Ⅱ fractures,4 type Ⅲ fractures,and 2 type Ⅳ fractures. Regular follow-up examinations were conducted to observe fracture healing,knee joint mobility,and complications. The Lysholm knee scoring and IKDC scoring were used to evaluate knee joint functions. Results The follow-up period ranged from 5 to 28 months,with a mean of (17.7±8.8) months. All wounds healed in the first stage without complications such as infection. Radiographic examination confirmed fracture healing in all patients,with a healing time ranging from 9 to 14 weeks (mean:12.1 weeks). There was no redislocation,malunion,or nonunion. At the final follow-up,knee flexion was restricted in 2 cases (range:0°-110°). All patients had negative results by anterior drawer and Lachman tests,with no evidence of physeal injury on X-ray. No complication such as pain or stiffness was reported,and patients were able to perform daily activities and participate in sports. The Lysholm knee score improved from a preoperative median of 32 (range:25-37) to 100 (range:98-100) (Z=2.937,P=0.003),and the IKDC score improved from a preoperative median of 30 (range:22-35) to 100 (range:95-100) (Z=2.943,P=0.003). Conclusions Arthroscopic high-strength suture fixation is effective in treating tibial eminence fractures in children and adolescents,demonstrating satisfactory clinical outcomes. It offers advantages such as minimal trauma,good reduction,secure fixation and early recovery,eliminating the need for secondary surgeries.