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Absorbable and non-absorbable suture fixation results in similar outcomes for tibial eminence fractures in children and adolescents

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

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.

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Acknowledgments

We thank the Merian Iselin Foundation Basel for their support in realizing this study. We thank Martha Murray and Shanika Coney for the language support.

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Authors and Affiliations

  1. Paediatric Orthopaedic Department, University Children’s Hospital Basle (UKBB), Spitalstrasse 33, 4056, Basel, Switzerland

    Stefan Brunner, Patrick Vavken, Erich Rutz, Reinald Brunner & Carlo Camathias

  2. Orthopaedic Department, University Hospital Basel, 4003, Basel, Switzerland

    Julia Vavken

  3. Department of Orthopedic Surgery, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA

    Patrick Vavken & Carlo Camathias

  4. Orthopädie am Rhy, 4055, Basel, Switzerland

    Robert Kilger

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  1. Stefan Brunner
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  2. Patrick Vavken
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  3. Robert Kilger
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Correspondence to Carlo Camathias.

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Brunner, S., Vavken, P., Kilger, R. et al. Absorbable and non-absorbable suture fixation results in similar outcomes for tibial eminence fractures in children and adolescents. Knee Surg Sports Traumatol Arthrosc 24, 723–729 (2016). https://doi.org/10.1007/s00167-015-3844-9

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  • DOI: https://doi.org/10.1007/s00167-015-3844-9

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