A Follow-up Study Of Arthroscopic Figure-of-eight Suture Fixation Through Epiphyseal Plate Treating The Anterior Cruciate Ligament Avulsion Fractures Of Tibia

Purpose: To investigate the outcome of the anterior cruciate ligament avulsion fractures of tibia in skeletally immature patients treated with arthroscopic reduction and pull-out suture fixation and evaluate its affect on epiphyseal plate growth by using this technique.Methods: From January 2003 to July 2006, 30 patients met the inclusion criteria. Their clinic data were analyzed retrospectively. According to Meyers-McKeever-Zaricznyj classification systems, there were 9 cases of typeⅡ, 18 cases of typeⅢ, and three cases of typeⅣ. The patients were treated with arthroscopic figure-of-eight suture fixation through epiphyseal plate. The patients were followed up and interviewed in out-patient department or by letters. The clinical results were evaluated according to IKDC and Lysholm and Tegner rating scales. The disturbance in growth was evaluated according to examining both lower limbs, comparing radiograph of both proximal tibia.Results: 27 cases were followed up for 34 months averagely (12 to 54 months), 17 cases were followed in out-patient department, other 10 cases by letters. At the last follow-up all the affected knees regained full range of motion. Functional assessment revealed excellent results. In 17 cases of out-patient, Lysholm score was on average 98.4±2.32, IKDC subjective score was on average 95.5±5.59, and Tegner score was on average 6.76±0.44. according to the IKDC knee examination form, 14 cases were graded A, three were graded B. 10 patients followed by letter showed the average Lysholm knee score was 99.5±1.58, the average Tegner score was 6.9±0.32,and the average IKDC Subjective score was 99.0±1.41. No patient was found growth disturbance.Conclusions: Arthroscopic figure-of-eight suture fixation through epiphyseal plate treating the anterior cruciate ligament avulsion fractures of tibia in skeletally immature patients has several advantages with minimal invasion, secure fixation, early mobilization, quick recovery, without second operation to remove the hardware. Moreover it will not intervene the growth plate.