Clinical Analysis of Tibial Spine Fractures Treated with Arthroscopic Surgery Using 2.0 mm Tibial Tunnel in Children and Adolescents

Objective: The purpose of this study was to evaluate the clinical results of tibial spine fractures treatment with arthroscopic surgery using 2.0 mm tibial tunnel in children and adolescents. Methods: A total of 25 children and adolescent patients with tibial spine fractures were classified using Meyers and Zaficzny methods and treated with the arthroscopic surgery using 2.0 mm tibial tunnel. The continuous passive motion (CPM) exercise was undertaken after 3 weeks of operation, and knee joint function was evaluated by the Lysholm score. The follow-up assessments were taken every half a year. Results: It was found that the operation time for reduction and internal fixation could be performed under an arthroscope in 1.5 h which was related to the age, and the interval between operation and injury. After 4 weeks of CPM exercise, knee joint reached full range of move (FROM), and there was a correlation between the time of postoperative CPM returned to normal FROM and the combined injuries. On average 6 weeks, X-ray diagnosis showed bony union and gradually weight-bearing. The Lysholm score for evaluating the knee functions after operation was 86-97 (average 93). At the last follow-up, the Lachman tests in all patients were negative, and no intra-articular infection, knee flexion limitation joint instability, and proximal tibial growth disturbance were observed. Conclusion: This method avoided epiphyseal injury, and could be conducted simply and effectively for fracture reduction and fixation in children and adolescents with tibial spine fractures.