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SCORPION ASSISTED ARTHROSCOPIC SUTURE FIXATION OF A DISPLACED TIBIAL EMINENCE FRACTURE



Abstract

Purpose of the study: We describe a new modified arthroscopic technique of surgically treating avulsion fractures of the tibial eminence using the Scorpion device (Arthrex, Naples, FL).

Methods and results: A 57 year-old female who sustained a type II fracture of the tibial spine was treated with arthroscopic fracture fixation using the Scorpion device to place a whip stitch into the substance of the anterior cruciate ligament (ACL). Tibial tunnels were made on the anteromedial aspect of the tibia using the Acufex ACL guide (Smith and Nephew, Mansfield, MA) and the sutures were passed through these tunnels and tied over a bony bridge. At 6 months after surgery, the patient was asymptomatic and had returned to her daily activities. She had regained full range of movement and had a clinically stable knee, confirmed on KT 2000 arthrometer. Radiographs showed anatomic reduction and fracture union.

Conclusion: The Scorpion device which is commonly used in arthroscopic shoulder surgery provides significant advantages as it can be used arthroscopically to place a whip stitch in the substance of the ACL. The hook at its end can be used to retrieve suture loop from the joint, thus reducing instrumentation and operating time. It is a user friendly arthroscopic technique that restores the necessary tension in the ACL, provides stable fracture fixation, and also results in a cosmetic end result.

Correspondence should be addressed to: BASK c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.