title: Absorbable and non-absorbable suture fixation results in similar outcomes for tibial eminence fractures in children and adolescents.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
  
  
  METHODS
  III.
authors.affiliation: Paediatric Orthopaedic Department, University Children's Hospital Basle (UKBB), Spitalstrasse 33, 4056, Basel, Switzerland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Brunner
authors.affiliation: Paediatric Orthopaedic Department, University Children's Hospital Basle (UKBB), Spitalstrasse 33, 4056, Basel, Switzerland.|Department of Orthopedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Patrick
authors.initials: P
authors.lastname: Vavken
authors.affiliation: Orthopädie am Rhy, 4055, Basel, Switzerland.
authors.forename: Robert
authors.initials: R
authors.lastname: Kilger
authors.affiliation: Orthopaedic Department, University Hospital Basel, 4003, Basel, Switzerland.
authors.forename: Julia
authors.initials: J
authors.lastname: Vavken
authors.affiliation: Paediatric Orthopaedic Department, University Children's Hospital Basle (UKBB), Spitalstrasse 33, 4056, Basel, Switzerland.
authors.forename: Erich
authors.initials: E
authors.lastname: Rutz
authors.affiliation: Paediatric Orthopaedic Department, University Children's Hospital Basle (UKBB), Spitalstrasse 33, 4056, Basel, Switzerland.
authors.forename: Reinald
authors.initials: R
authors.lastname: Brunner
authors.affiliation: Paediatric Orthopaedic Department, University Children's Hospital Basle (UKBB), Spitalstrasse 33, 4056, Basel, Switzerland. camathias.carlo@gmail.com.|Department of Orthopedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA. camathias.carlo@gmail.com.
authors.forename: Carlo
authors.initials: C
authors.lastname: Camathias
mesh_terms: D000293:Adolescent; D001182:Arthroscopy; D001863:Bone Screws; D002648:Child; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D008297:Male; D013536:Suture Techniques; D013537:Sutures; D013978:Tibial Fractures / Q000175:diagnosis / Q000601:surgery*; D014945:Wound Healing
keywords: Absorbable; Anterior cruciate ligament ACL; Non-absorbable; Physeal sparing; Skeletally immature; Suture fixation; Tibial eminence fracture