Injuries of ACL with Avulsion of Bone Fragment from Tibial Intercondylar Eminence in Children and Adolescents


Experience in arthroscopic treatment of 54 patients aged 5-18 years with ACL injury and bone fragment avulsion from the tibial intercondylar eminence is presented. Type I injury (by Meyers & McKeever - Zaricznyi classification) was diagnosed in 2 %, type II - in 49%, type III - in 40% and type IV - in 9% of patients. In patients with type I injury arthroscopic intervention was performed for concomitant injuries diagnosis and knee joint sanitation. In patients with II-IV types of injury arthroscopic osteosynthesis of tibial intercondylar eminence fractures with wire loop by original technique was performed. Excellent results were achieved in 44 (81.1%), good - in 7 (12.1%) and satisfactory - in 3 (6.8%) patients. Neither complications nor cases of nonunion were noted. Advantages of the proposed technique are the minimal traumatization of tibial growth zone, rigid fracture fixation, possibility to use this method of fixation in comminuted fractures

About the authors

V. N Merkulov

Central Institute of Traumatology and Orthopaedics named after N.N. Priorov, Moscow, Russia

R. K Dovluru

Central Institute of Traumatology and Orthopaedics named after N.N. Priorov, Moscow, Russia


A. G El’tsin

Central Institute of Traumatology and Orthopaedics named after N.N. Priorov, Moscow, Russia

D. S Mininkov

Central Institute of Traumatology and Orthopaedics named after N.N. Priorov, Moscow, Russia


  1. Golanski G., Flont P., Lipczyk Z., Niedzielski K.R. Results of treatment of the intercondylar eminence of tibia in children. Chir. Narzadow Ruchu. Ortop. Pol. 2010: 75 (5): 305-11.
  2. Бухны А.Ф. Повреждения эпифизарных зон костей у детей. М.: Медицина; 1973.
  3. Noyes. F.R., Delucas J.L., Torvik P.J. Biomechanics of anterior cruciate ligament failure: an analysis of strain- rate sensitivity and mechanisms of failure in primates. J. Bone Joint Surg. Am. 1978; 56: 236-53.
  4. Wilfinger C., Castellani C., Raith J., Pilhatsch A., Hollwarth M.E., Weinberg A.M. Nonoperative treatment of tibial spine fractures in children. J. Orthop. Trauma. 2009; 2 3 (7): 519-24.
  5. Sun K., Gai P.Z., Xu Q., Liu J.Z., Yu T.B., Tian S.Q. A study of three different procedures for avulsion fracture of tibial intercondylar eminence. Zhonghua Wai Ke Za Zhi. 2008; 46 (4); 270-3.
  6. Iborra J.P., Mazeau P., Louahem D., Dimeglio A. Fractures of the intercondylar eminence of the tibia in children. Rev. Chir. Orthop. Reparatrice Appar. Mot. 1999; 85 (6): 563-73.
  7. Meyers M.H., Mckeever F.M. Fracture of the Intercondylar eminence of the tibia. J. Bone Joint Surg. Am. 1959; 41 (2): 209-22.
  8. Zaricznyj B. Avulsion fracture of the tibial eminence: treatment by open reduction and pinning. J. Bone Joint Surg. Am. 1997; 59 (8): 1111-4.
  9. Стужина В.Т. Повреждение области коленного сустава у детей и подростков при занятиях спортом и их лечение. В кн.: Сборник научных трудов «Заболевания и повреждения нижних конечностей у детей». Ленинград; 1990: 84-7.
  10. Бальтер С.А., Лукьянченко А.Б. Применение ЯМР-томографии в клинической практике. Вестник рентгенологии и радиологии. 1986; 3: 79-83.
  11. Меркулов В.Н., Ельцин А.Г., Мининков Д.С., Довлуру Р.К., Самбатов Б.Г. Способ артроскопического остеосинтеза переломов межмыщелкового возвышения большеберцовой кости. Патент РФ № 2387399 от 27.04.2010.
  12. Миронов С.П., Орлецкий А.К., Цыкунов М.Б. Повреждения связок коленного сустава. М.: Медицина; 1999.
  13. Зар B.B. Артроскопическая диагностика и лечение внутрисуставных повреждений коленного сустава: Автореф. дис.. канд. мед. наук. М.; 1995.
  14. Purushottam A.G., Kurt V.V., Melih G. Arthrofibrosis of the knee after tibial spine fracture in children. HSS J. 2008; 4 (1): 14-9.
  15. Fabricant P.D., Osbahr D.C., Green D.W. Management of a rare complication after screw fixation of a pediatric tibial spine avulsion fracture: a case report with follow- up to skeletal maturity. J. Orthop. Trauma. 2011; 25 (12): 115-9.
  16. Kieser D.C., Gwynne-Jones D., Dreyer S. Displaced tibial intercondylar eminence fractures. J. Orthop. Surg. (Hong Kong). 2011; 19 (3): 292-6



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