Stefan Brunner1, Patrick Vavken1,2, Robert Kilger3, Julia Vavken4, Erich Rutz1, Reinald Brunner1, Carlo Camathias5,6. 1. Paediatric Orthopaedic Department, University Children's Hospital Basle (UKBB), Spitalstrasse 33, 4056, Basel, Switzerland. 2. Department of Orthopedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA. 3. Orthopädie am Rhy, 4055, Basel, Switzerland. 4. Orthopaedic Department, University Hospital Basel, 4003, Basel, Switzerland. 5. Paediatric Orthopaedic Department, University Children's Hospital Basle (UKBB), Spitalstrasse 33, 4056, Basel, Switzerland. camathias.carlo@gmail.com. 6. Department of Orthopedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA. camathias.carlo@gmail.com.
Abstract
PURPOSE: To evaluate efficacy and safety of extraphyseal tibial eminence avulsion fracture repair with absorbable sutures and a distal bone bridge fixation in comparison to previously described technique with non-absorbable sutures and distal screw fixation. METHODS: In a physeal-sparing technique, tibial eminence fractures (n = 25; McKeever type II/III n = 11/14) were either treated in group A (n = 15, follow-up 28.1 months) using an absorbable suture fixed over a bone bridge or in group B (n = 10, follow-up 47.4 months) with a non-absorbable suture wrapped around an extraarticular tibial screw. IKDC and Lysholm scores were assessed, and the difference between the surgical and contralateral knee in anteroposterior (AP) translation, measured with a Rolimeter. RESULTS: There was no significant difference between group A and group B in IKDC and Lysholm scores with 90.1 points ± 10.2 and 94.1 points ± 8.1, respectively (n.s.). AP translation did not differ between groups (n.s.). Eight of ten screws in group B had to be removed in a second intervention. A total of four arthrofibroses were counted (three in group A). CONCLUSION: Extraphyseal tibial eminence repair with absorbable sutures and a distal bone bridge fixation results in similar rates of radiographic and clinical healing at 3 months after surgery as non-absorbable sutures tied around a screw, while avoiding the need for hardware removal. The minimal invasive technique to fix an eminence fracture without any permanent sutures or hardware is advantageous for children. To our knowledge, this is the first study that compares non-absorbable with absorbable sutures for a physeal-sparing technique. LEVEL OF EVIDENCE: III.
PURPOSE: To evaluate efficacy and safety of extraphyseal tibial eminence avulsion fracture repair with absorbable sutures and a distal bone bridge fixation in comparison to previously described technique with non-absorbable sutures and distal screw fixation. METHODS: In a physeal-sparing technique, tibial eminence fractures (n = 25; McKeever type II/III n = 11/14) were either treated in group A (n = 15, follow-up 28.1 months) using an absorbable suture fixed over a bone bridge or in group B (n = 10, follow-up 47.4 months) with a non-absorbable suture wrapped around an extraarticular tibial screw. IKDC and Lysholm scores were assessed, and the difference between the surgical and contralateral knee in anteroposterior (AP) translation, measured with a Rolimeter. RESULTS: There was no significant difference between group A and group B in IKDC and Lysholm scores with 90.1 points ± 10.2 and 94.1 points ± 8.1, respectively (n.s.). AP translation did not differ between groups (n.s.). Eight of ten screws in group B had to be removed in a second intervention. A total of four arthrofibroses were counted (three in group A). CONCLUSION: Extraphyseal tibial eminence repair with absorbable sutures and a distal bone bridge fixation results in similar rates of radiographic and clinical healing at 3 months after surgery as non-absorbable sutures tied around a screw, while avoiding the need for hardware removal. The minimal invasive technique to fix an eminence fracture without any permanent sutures or hardware is advantageous for children. To our knowledge, this is the first study that compares non-absorbable with absorbable sutures for a physeal-sparing technique. LEVEL OF EVIDENCE: III.
Authors: Matthew R Bong; Anthony Romero; Erik Kubiak; Kazuho Iesaka; Christian S Heywood; Fredrick Kummer; Jeffrey Rosen; Laith Jazrawi Journal: Arthroscopy Date: 2005-10 Impact factor: 4.772
Authors: Matthias J Feucht; Peter U Brucker; Carlo Camathias; Karl-Heinz Frosch; Michael T Hirschmann; Stephan Lorenz; Hermann O Mayr; Philipp Minzlaff; Wolf Petersen; Tim Saier; Dorien Schneidmüller; Amelie Stoehr; Daniel Wagner; Norbert P Südkamp; Philipp Niemeyer Journal: Knee Surg Sports Traumatol Arthrosc Date: 2016-05-27 Impact factor: 4.342