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Tibial Eminence Fractures in Children: Prevalence of Meniscal Entrapment

From the Division of Sports Medicine, Department of Orthopaedic Surgery, Children’s Hospital, Harvard Medical School, Boston, Massachusetts

^* Address correspondence and reprint requests to Mininder S. Kocher, MD, MPH, Department of Orthopaedic Surgery, Children’s Hospital, 300 Longwood Avenue, Boston, MA 02115

Background: Meniscal entrapment under a displaced tibial eminence fragment may be a rationale for arthroscopic or open reduction in type 2 and 3 tibial eminence fractures.

Purpose: To determine the prevalence of meniscal entrapment in children with type 2 and 3 tibial eminence fractures.

Study Design: Case series.

Methods: Records of a consecutive series of 80 skeletally immature patients (mean age, 11.6 years; range, 5 to 16) who underwent arthroscopic (71), open (5), or combined arthroscopic and open (4) reduction and internal fixation of type 3 tibial eminence fractures (57) or type 2 fractures that did not reduce in extension (23) from 1993 to 2001 were reviewed.

Results: Entrapment of the anterior horn of the medial meniscus (36), intermeniscal ligament (6), or anterior horn of the lateral meniscus (1) was seen in 26% (6 of 23) of type 2 fractures and 65% (37 of 57) of type 3 fractures. An associated meniscal tear was seen in 3.8% of patients (3 of 80).

Conclusions: Meniscal entrapment is common in patients with type 2 and 3 tibial eminence fractures. Arthroscopic or open reduction should be considered for type 3 fractures and for type 2 fractures that do not reduce in extension to remove the incarcerated meniscus, allowing for anatomic reduction.

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