Cannulated screw fixation versus high-strength suture fixation in arthroscopy of tibial intercondylar fracture

Objective To compare the cannulated screw fixation versus high-strength suture fixation in arthroscopy of tibial intercondylar fracture. Methods A retrospective analysis was performed of the 31 patients with tibial intercondylar fracture who had been treated from February 2015 to February 2018 at Department of Orthopaedics, Beijing Renhe Hospital. They were 18 males and 13 females with an average age of 34.3 years (range, from 21 to 51 years). Arthroscopic cannulated screw fixation was conducted in 13 patients (screwing group), 5 of whom were McKeever type Ⅱ and 8 of whom McKeever type Ⅲ. Arthroscopic high-intensity suture fixation was used in 18 patients (suture group), 6 of whom were McKeever type Ⅱ and 12 of whom McKeever type Ⅲ. The 2 groups were compared postoperatively in terms of operation time, hospitalization time, fracture healing time, Lysholm knee scores and rate of secondary operation. Results The 2 groups were comparable because there were no significant differences in preoperative general data between them (P>0.05). All the patients were followed up for 12 to 44 months (mean, 24.8 months). For the screwing and suture groups, respectively, operation time was 91.6 min±7.6 min and 91.9 min±7.4 min, hospitalization time 11.5 d±2.9 d and 11.4 d±2.3 d and fracture healing time 3.3 mon±0.5 mon and 3.3 mon±0.6 mon, showing no significant differences between the 2 groups (P>0.05). By the Lysholm scores at 12 months after operation, the screwing group scored from 65 to100 points with an excellent and good rate of 92.3% (12/13), and the suture group from 60 to 100 points with an excellent and good rate of 94.4% (17/18), showing no significant difference between the 2 groups (P>0.05). Ten patients (76.9%) in the screwing group had secondary arthroscopy to remove the implants but none in the suture group did. Conclusions Both cannulated screw fixation and high-strength suture fixation can achieve satisfactory clinical results in the arthroscopy of tibial intercondylar fractures, but the latter may lead to a lower rate of secondary operation. Key words: Arthroscopy; Fracture fixation, internal; Bone nails; High strength suture; Tibial eminence fracture