Tibial Eminence Fractures in Children: Prevalence of Meniscal Entrapment

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.