Arthroscopic Fixation of Tibial Spine Fractures

The medial and lateral tibial spines constitute the most distal aspect of the anterior cruciate ligament complex. The integrity of the anterior cruciate ligament and its femoral and tibial attachments is essential for proper knee kinematics. Tibial spine fractures represent a vio-lation of this complex, which, if untreated, can lead to pain, stiffness, instability, and functional limitation. Con-sequently, accurate diagnosis and prompt treatment are important to restore stability and function to the knee. Associated intraarticular injuries commonly occur with tibial spine avulsion fractures and can affect outcome. Because of greater energy and a different mechanism of injury, adults sustain concomitant intra-articular injuries more frequently than the child or adolescent. Recognizing and treating these associated injuries as well as reduction and appropriate fixation of the tibial spine fracture is essential for a satisfactory outcome. Displaced fractures should be treated surgi-cally. In general, surgical options include reduction and fixation through an arthrotomy or arthroscopic techni-ques. Arthroscopy is now becoming an integral part of tibial spine fracture management. Arthroscopy allows for accurate diagnosis and treatment of associated injuries and reduction and fixation of all types of tibial spine fractures while reducing the morbidity associated with open techniques