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KMID : 0359619960080010103
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Journal of Korean Knee Society
1996 Volume.8 No. 1 p.103 ~ p.107
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Arthroscopic Pull-out Wire Fixation of Tibial Eminence Fractures
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Abstract
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Anatomical reduction of fragment is of paramount importance in the treatment of displaced tibial eminence fractures to establish the length of the anterior cruciate ligament(ACL) and to restore the stability of the knee joint. A few successful
arthroscopic reduction and fixation have been reported in the recent literature offering a new treatment option.
In this report we describe a procedure of arthroscopic reduction and pull-out wire fixation of the displaced tibial eminence fractures. Five patients(one female, four males) with displaced tibial eminence fractures were treated using this
procedure.
Average age was 27 years(range 21-46). Three patients had type III and two had type IV fracture. After adequate arthroscopic reduction of fracture fragment., two 2.0 mm Steinmann pins that have a hole at the end were placed transtibially into the
edge
of fracture fragment from the anterior surface of proximal tibial using the tibial ACL drill guide. 22-gauge wire was introduced into each hole, pulled down and tied directly onto the anterior tibial cortex. Early postoperative rehabilitation
program
including immediate range-of-motion exercise and partial weight bearing as tolerated was initiated. After 6 weeks, full weight bearing were pemitted.
All patients regained normal range of flexion and extension and had returned to athletic activities with no restrictions. No patients had subjective complaints of instability and demonstrated side-to-side difference in the manual maximal
displacement
tests of the KT-2000 arthrometer studies at an average.
Follow-up of 1 year.
Although it is a technically demanding procedure, arthroscopic reduction and pull-out wire fixation of displaced tibial eminence fractures provides stable surgical fixation with minimal-morbidity.
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