Arthroscopic Treatment Of Tibial Intercondylar Spine Fracture In Children By Arthroscopic Epiphyseal Plate Fixation With PDS-Ⅱ Line Combined With Endobutton

Objective : To explore the operative method and effect of arthroscopic treatment of tibial intercondylar spine fracture with PDS-Ⅱ line combined with Endobutton through a single tunnel,so as to provide an effective,safe and reliable method for arthroscopic treatment of tibial intercondylar spine fracture in children.Methods:The clinical data of 11 children with tibial intercondylar spine fracture diagnosed and treated in plastic surgery hospital from October 2018 to October 2021 and followed up for more than half a year were analyzed retrospectively.According to Meyers-Mckeever fracture type,there were 4 cases of type Ⅱ and 7 cases of type Ⅲ.Under the monitoring of arthroscopy,the fracture end was cleaned and the tibial intercondylar spine was reduced.A 2mm bone tunnel was located and drilled at about 5 o’clock above the epiphyseal plate by using the tibial guide of the anterior cruciate ligament.The root of the anterior cruciate ligament was ligated with double-stranded Pudis suture(PDS-Ⅱ),and then tightened and knotted and fixed through the Endobutton.After the operation,the patients were guided by functional rehabilitation training and the outpatients were followed up regularly.The comprehensive recovery was evaluated by knee joint Lysholm score,2000 IKDC knee subjective score,FIM scale score and VAS score of pain.The incidence of complications and the excellent and good rate of knee joint function recovery were recorded to evaluate the effectiveness,safety and reliability of arthroscopic treatment of tibial intercondylar spine fracture with PDS-Ⅱ line combined with Endobutton fixation through a single tunnel.Results: The patients were followed up for 6 to 12 months(mean 9.4months).The fracture healed at stage one 3 months after operation,and the knee joint Lysholm score,2000 IKDC knee subjective score and FIM scale score were significantly higher than those before operation.The VAS score of pain of the last follow-up was significantly lower than that before and 2 weeks after operation.The excellent and good rate of knee joint function recovery was 100%,and there were no other related complications.Conclusions:Arthroscopic treatment of tibial intercondylar spine fracture with PDS-Ⅱ line combined with Endobutton fixation through a single tunnel is a minimally invasive and reliable method with short learning curve and avoiding the related complications of injury of epiphyseal plate.