경골 과간융기 골절의 관절경적 Pull - out 철사 고정술

• Published in: Knee surgery & related research Vol. 8; no. 1; pp. 103 - 107
• Main Authors: 하권익, 김승호, 윤경호, Kwon Ick Ha, Seung Ho Kim, Kyoung Ho Yoon
• Format: Journal Article
• Language: Korean
• Published: 대한슬관절학회 30.06.1996
• Subjects: Arthroscopic pull - out wiring; Tibial eminence fracture
• ISSN: 2234-0726

Anatomical reduction of fragment is of paramount importance in the treal.ment of displaced tihial 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 heen 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 thc anterior surface ot proximal tibia using the tibia1 ACL drill guide. 22-gauge wire was introduceci into each hole, pulled down and tied directly onto the anterior tibial cortex. Early postoperative rehabilitation program including irnmediate range-of-motion exercise and part.ial weight he,aring as toleratecl was initiated. After 6 weeks, full weight bearing were pemitted. All patients regained normal range of flexion and exfension and had returned to at]iletic activilies 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.