title: Arthroscopic 4-point suture fixation of anterior cruciate ligament tibial avulsion fractures.
abstract: Tibial eminence avulsion fractures are rare injuries occurring mainly in adolescents and young adults. When necessary, regardless of patient age, anatomic reduction and stable internal fixation are mandatory for fracture healing and accurate restoration of normal knee biomechanics. Various arthroscopically assisted fixation methods with sutures, anchors, wires, or screws have been described but can be technically demanding, thus elongating operative times. The purpose of this article is to present a technical variation of arthroscopic suture fixation of anterior cruciate ligament avulsion fractures. Using thoracic drain needles over 2.4-mm anterior cruciate ligament tibial guidewires, we recommend the safe and easy creation of four 2.9-mm tibial tunnels at different angles and at specific points. This technique uses thoracic drain needles as suture passage cannulas and offers 4-point fixation stability, avoiding potential complications of bony bridge fracture and tunnel connection.
authors: First Orthopaedic Department, Aristotle University of Thessaloniki, "G. Papanikolaou" General Hospital, Thessaloniki, Greece.
authors: Achilleas
authors: A
authors: Boutsiadis
authors: Department of Orthopaedics, General Clinic, Blue Cross, Euromedica, Thessaloniki, Greece.
authors: Dimitrios
authors: D
authors: Karataglis
authors: First Orthopaedic Department, Aristotle University of Thessaloniki, "G. Papanikolaou" General Hospital, Thessaloniki, Greece.
authors: Filon
authors: F
authors: Agathangelidis
authors: First Orthopaedic Department, Aristotle University of Thessaloniki, "G. Papanikolaou" General Hospital, Thessaloniki, Greece.
authors: Konstantinos
authors: K
authors: Ditsios
authors: First Orthopaedic Department, Aristotle University of Thessaloniki, "G. Papanikolaou" General Hospital, Thessaloniki, Greece.
authors: Pericles
authors: P
authors: Papadopoulos