Intercondylar Eminence Fracture in Children. Results of Long-Term Follow-up

Abstract

PURPOSE OF THE STUDY An intercondylar eminence fracture is injury more common in children and adolescents than in adults. Also if it is considered a benign lesion, a displaced medial spine fracture can result in cruciate ligament laxity. We report the evaluation of long-term results of conservative and arthroscopic stabilisation in children and adolescents with different types of intercondylar eminence fracture. MATERIAL AND METHODS Flirty-eight patients with intercondylar eminence fractures, 31 boys and 17 girls, were included in our retrospective study. Of them, 33 were at the end of skeletal growth. According to the Meyers and McKeever classification, 11 fractures were type I, 20 were type II and 17 were type III. The first step in the treatment was an attempt at conservative reduction. If it failed, arthroscopic reduction with crossed K-wire fixation was used. At clinical follow-up, the patients were examined for pain, range of motion, level of activity, and the laxity tests were done. RESULTS Conservative treatment was used in all type I cases (100 %), in eight type II cases (40%) and three type III cases (18%). The remaining patients were treated by arthroscopic reduction with crossed K- wires (type I, 0%; type II, 60%; type III, 82%). Six patients (12.5%) had symptoms of persistent anterior instability and five of them (10.4%) were indicated for anterior ligament reconstruction at the end of skeletal growth. We did not see serious complications. DISCUSSION Most of the authors recommend that type I and type II fractures should be treated conservatively; type III is better treated by arthroscopic reduction. Some of type II and type III fractures are indicated for minimally invasive surgical treatment at once. At the present time at our department, type II and some type III fractures are indicated first for conservative reduction and, when this fails, arthroscopic reduction with K-wire fixation is used. CONCLUSIONS The aim of our report was to report the results of our study and present our relatively conservative way of treatment as the method of choice for treating intercondylar eminence fractures in children and adolescents.