,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,Arthroscopic Reduction and Internal Fixation of TibialEminence Fractures,once thought to occur only in the pediatric population,in adults as well.,Fractures of the tibial intercondylar eminence,The ability to arthroscopically,1.evaluate the fracture pattern,2.address concomitant intraarticular pathology.,Cannulated screw fixation has been shown to have good strength and fracture stabilization.,Existing problems,1.smaller or comminuted fracture fragments,2.The potential for hardware impingement with the subsequent loss of knee extension,3.coupled with the possibility of screw removal,suture fixation is biomechanically stronger than screw fixation.,Surgical Technique,Created a central transpatellar portal,a superior percutaneous 4.5-mm K-wire may be used to obtain provisional fixation.,Surgical Technique,A No.5 FiberWire is then shuttled through the base of the ACL with the SutureLasso.,Surgical Technique,The ACL guide system is used to drill 2 parallel tunnels within the tibia.,Surgical Technique,unscrews and removes the inner drill bit while leaving the outer cannulated drill sleeve in place,A Nitinol suture loop is then passed up through the outer cannulated drill bit into the knee.,Surgical Technique,One end of the No.5 FiberWire is then shuttled by use of the Nitinol loop from the working portal down the medial tunnel and out the anterior aspect of the tibia.,Surgical Technique,The other end of the No.5 FiberWire is shuttled in the same manner out of the second drill hole.The reduction is confirmed,and the suture is then tied over a bony bridge on the anteriormedial cortex of the tibia.,Discussion,Arthroscopic has advanced to become the preferred method of treatment,The addition of the cannulated drill significantly simplifies the process of suture passage while maintaining fracture reduction and minimizing surgical steps.,Thank you for your attention,