Arthroscopic suture fixation of tibial spine fractures

A tibial spine fracture refers to an intraarticular fracture of the osseous insertion of the anterior cruciate ligament at the proximal tibia, commonly seen in paediatric and adolescent patients. This fracture is classified based on the degree of displacement and the presence or absence of an intact posterior hinge point. For significantly displaced fractures, surgical reduction and fixation is often recommended. Both open and arthroscopic approaches have been described. This technical note describes our technique for arthroscopic assisted reduction and fixation of tibial spine fractures using trans-osseous tunnels and suture fixation over a bone bridge. This technique restores native anatomy, provides fracture compression and has favourable biomechanical properties allowing for early range of motion.