{
    "abstract": "The surgical goal is the arthroscopically assisted, closed reduction, and suture osteosynthesis of fractures of the tibial eminence in children and adolescents.\nFractures of the tibial eminence type (II)-III according to Meyers & McKeever or type\u00a0IV according to Zaricznyj.\nFracture of the tibial eminence type\u00a0I, conservatively treatable fracture type\u00a0II according to Meyers & McKeever and ligamentous rupture of the anterior cruciate ligament.\nSupine position. Securing the leg with a\u00a0lateral support on the thigh and a\u00a0roll to support the foot in\u00a090\u00b0 kneeflexion. Unwrap for blood evacuation with cuff on the thigh. Creation of the anterolateral portal and filling of the joint with Ringer's solution. Usually, extensive irrigation of the hemarthrosis is required first to gain visibility. Then the anteromedial portal is created. A\u00a0diagnostic walk-around is performed to rule out concomitant injuries to the cartilage and menisci. The fracture bed is then debrided with the shaver and the fracture is reduced on a\u00a0trial basis using the cruciate ligament targeting device. Remove the cruciate ligament targeting device and reinforce the anterior cruciate ligament (ACL) with a\u00a0suture shuttle forceps with two 1\u00a0Polysorb\nRemoval of the femoral cast sleeve and radiological consolidation control 6 weeks postoperatively. Then start physiotherapy to restore the anatomical range of motion and strengthen thigh muscles.\nWe operated on 10 patients between 2019 and 2022. Of these, 60% were boys. Age ranged from 5-14 years with a median of 8 years and a mean of 8.6 years. The right and left knee were affected half each; 20% of the patients presented a type II injury and 80% a type III according to Meyers & McKeever. One patient had to be revised in the course due to a cyclops lesion. One patient also presented a partial ACL rupture intraoperatively, but this has not shown any clinical relevance in the postoperative course to date. In the Lysholm score, we achieved a mean of 90.4 points and a median of 97.5 points. The International Knee Documentation Committee (IKDC) score resulted in a mean of 90.9% and a median of 90.25%. In addition, the pre- and postoperative tibial slope and the postoperative range-of-motion values were collected.\nOPERATIONSZIEL: Arthroskopisch assistierte, geschlossene Reposition und Fadenosteosynthese von Frakturen der Eminentia intercondylaris bei Kindern und Jugendlichen.\nFrakturen der Eminentia intercondylaris Typ (II\u2013)III nach Meyers & McKeever bzw. Typ\u00a0IV nach Zaricznyj.\nDie Fraktur der Eminentia intercondylaris Typ\u00a0I, die konservativ therapiebare Fraktur Typ\u00a0II nach Meyers & McKeever sowie die ligament\u00e4re Ruptur des vorderen Kreuzbands.\nR\u00fcckenlage. Bein an Seitst\u00fctze am Oberschenkel sowie einer Rolle am Fu\u00df in\u00a090\u00b0 Knieflexion. Blutleere am Oberschenkel. Anlage des anterolateralen Portals. Auff\u00fcllen des Gelenks mit Ringer-L\u00f6sung und ausgiebiges Sp\u00fclen des H\u00e4marthros. Anlage des antermedialen Portals. Nun diagnostischer Rundgang, um Begleitverletzungen auszuschlie\u00dfen. D\u00e9bridement des Frakturbetts mit dem Shaver. Probeweise Reposition der Fraktur mithilfe des Kreuzbandzielger\u00e4tes. Entfernen des Kreuzbandzielger\u00e4tes und Armierung des vorderen Kreuzbands mit einer Faden-Shuttle-Zange mit 2 1er-Polysorb\nKeine Entfernung des Osteosynthesematerials n\u00f6tig. Ruhigstellung in Oberschenkel-Cast-H\u00fclse f\u00fcr 6\u00a0Wochen. Abnahme der Oberschenkel-Cast-H\u00fclse und radiologische Konsolidierungskontrolle 6\u00a0Wochen postoperativ. Sodann Beginn mit Krankengymnastik zur Wiederherstellung des anatomischen Bewegungsumfangs und Kr\u00e4ftigung der Oberschenkelmuskulatur.\nIm Zeitraum von 2019 bis 2022 haben wir 10\u00a0Patienten operiert. Ein Patient musste im Verlauf aufgrund einer Zyklops-L\u00e4sion revidiert werden. Ein Patient pr\u00e4sentierte intraoperativ zus\u00e4tzlich eine VKB-Teilruptur, die aber im postoperativen Verlauf bis dato keine klinische Relevanz zeigt. Im Lysholm-Score erreichten wir einen Mittelwert von 90,4 Punkten und einen Median von 97,5 Punkten. Der IKDC-Score ergab einen Mittelwert von 90,9\u202f% und einen Median von 90,25\u202f%. Zudem wurden der pr\u00e4- und postoperative Tibiaslope sowie die postoperativen ROM-Werte erhoben.",
    "authors": [
        {
            "affiliation": "Sektion Kinder- und Neuroorthop\u00e4die, Klinikum Dritter Orden, Menzingerstr.\u00a044, 80638, M\u00fcnchen, Deutschland. vincent.frimberger@dritter-orden.de.",
            "firstname": "Vincent",
            "initials": "V",
            "lastname": "Frimberger"
        },
        {
            "affiliation": "Sektion Kinder- und Neuroorthop\u00e4die, Klinikum Dritter Orden, Menzingerstr.\u00a044, 80638, M\u00fcnchen, Deutschland.",
            "firstname": "Nina",
            "initials": "N",
            "lastname": "Berger"
        },
        {
            "affiliation": "Klinik f\u00fcr Kinderchirurgie, Klinikum Dritter Orden, M\u00fcnchen, Deutschland.",
            "firstname": "Stephan",
            "initials": "S",
            "lastname": "Kellnar"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.\n\u00a9 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.",
    "doi": "10.1007/s00064-024-00876-4\n10.1007/s10140-013-1121-0\n10.1016/j.arthro.2004.09.031\n10.1055/s-0038-1636544\n10.1097/01241398-200303000-00013\n10.3109/17453678709146348\n10.1097/BPO.0000000000000249\n10.1097/BPO.0000000000001110\n10.2106/00004623-197052080-00024\n10.2106/00004623-197759080-00022\n10.1093/bmb/ldw018\n10.3390/children9121897\n10.1007/s00167-015-3844-9\n10.1186/s13018-022-03219-w\n10.1016/j.otsr.2021.103021\n10.1007/BF00420267\n10.1007/s00064-008-1403-y\n10.1053/jars.2001.24706\n10.1016/0020-1383(84)90005-6\n10.1177/03635465010290051301\n10.1097/01241398-199501000-00014\n10.1097/BPO.0000000000001011\n10.1007/s00402-006-0282-7\n10.1177/2325967119881961\n10.1016/j.arthro.2003.11.028\n10.1097/TA.0b013e3182319d5a",
    "journal": "Operative Orthopadie und Traumatologie",
    "keywords": [
        "Adolescents",
        "Anterior cruciate ligament",
        "Avulsion fracture",
        "Children",
        "Intercondylar eminence",
        "Knee-Arthroscopy"
    ],
    "methods": null,
    "publication_date": "2024-11-21",
    "pubmed_id": "39570379\n23525909\n15650672\n29514374\n12604951\n3577744\n24992346\n29227373\n5483091\n591548\n27151952\n36553339\n26520645\n35752828\n34314904\n8457407\n11694938\n6546374\n11573919\n7883930\n17310373\n14760342\n22328000",
    "results": "We operated on 10 patients between 2019 and 2022. Of these, 60% were boys. Age ranged from 5-14 years with a median of 8 years and a mean of 8.6 years. The right and left knee were affected half each; 20% of the patients presented a type II injury and 80% a type III according to Meyers & McKeever. One patient had to be revised in the course due to a cyclops lesion. One patient also presented a partial ACL rupture intraoperatively, but this has not shown any clinical relevance in the postoperative course to date. In the Lysholm score, we achieved a mean of 90.4 points and a median of 97.5 points. The International Knee Documentation Committee (IKDC) score resulted in a mean of 90.9% and a median of 90.25%. In addition, the pre- and postoperative tibial slope and the postoperative range-of-motion values were collected.",
    "title": "[Arthroscopically assisted suture osteosynthesis of tibial eminence fractures in children and adolescents].",
    "xml": "<Element 'PubmedArticle' at 0x788503cec7c0>"
}