title: Arthroscopic fixation with EndoButton for tibial eminence fractures visualised through a proximal superomedial portal: a surgical technique.
abstract: Most tibial eminence fractures are avulsion fractures of the anterior cruciate ligament (ACL) from its tibial insertion. This study describes a new arthroscopic technique using an additional proximal superomedial portal to visualise the tibial eminence fracture and to fix the fracture with the EndoButton to avoid the risk of fragment breakage. The proximal superomedial portal enables fracture reduction without damage to the intermeniscal ligament. Fixation with the EndoButton is strong enough to allow early rehabilitation with vigorous exercise. All 5 patients achieved bone union; no young patient had growth disturbance of the tibia; all knees were stable with excellent range of motion and negative Lachman and pivot shift tests and no flexion contracture. Arthroscopic fixation with the EndoButton visualised through the proximal superomedial portal is a safe, simple, and secure method for treating tibial eminence fractures, particularly in children with small fragments.
authors.affiliation: Department of Orthopaedic Surgery, Shin-Kaminokawa Hospital, Tochigi, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sekiya
authors.affiliation: Department of Orthopaedic Surgery, Shin-Kaminokawa Hospital, Tochigi, Japan.
authors.forename: Kenzo
authors.initials: K
authors.lastname: Takatoku
authors.affiliation: Department of Orthopaedic Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Akinori
authors.initials: A
authors.lastname: Kimura
authors.affiliation: Department of Orthopaedic Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kanaya
authors.affiliation: Department of Orthopaedic Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Fukushima
authors.affiliation: Department of Orthopaedic Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Katsushi
authors.initials: K
authors.lastname: Takeshita
mesh_terms: D000293:Adolescent; D000368:Aged; D000070598:Anterior Cruciate Ligament Injuries / Q000150:complications / Q000601:surgery*; D001182:Arthroscopy / Q000379:methods*; D002648:Child; D015331:Cohort Studies; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D016059:Range of Motion, Articular; D013978:Tibial Fractures / Q000150:complications / Q000601:surgery*; D055815:Young Adult