Arthroscopic fixation of intercondylar eminence fractures using a 4-portal technique.

PURPOSE: We report an easy-to-use 4-portal technique for arthroscopic treatment of intercondylar eminence fractures and compare results of 2 groups of cases, adolescents and adults, and 2 types of internal fixation, sutures and screws.

TYPE OF STUDY: Surgical technique and retrospective study.

METHODS: The study was carried on 2 groups of patients, adolescents and adults, with intercondylar eminence fractures who were treated arthroscopically. For internal fixation, sutures were used in 8 adolescents and screws were used in 13 adults. In the technique we describe, anteromedial superior and inferior, and anterolateral superior and inferior portals were used.

RESULTS: The average follow-up period for the adolescents was 27.3 months (range, 11 to 57 months), and for the adults was 19.6 months (range, 7 to 71 months). We did not encounter any cases of nonunion. There were only 3 complications, 1 of arthrofibrosis resulting from a delay of rehabilitation due to a vascular compromise and 2 cases of tenderness over the screw that responded well to its removal. Union occurred earlier in adolescents, but rehabilitation was easier in adults.

CONCLUSIONS: Beside satisfactory results obtained by arthroscopic treatment of intercondylar eminence fractures, arthroscopy also provides the possibility to determine and treat associated pathologies. With the experience we gained, the procedure with the 4-portal technique in treating these fractures became much easier as a routine approach.