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Tibial eminence fx's -- associated with more narrow femoral notch vs pts that tear their ACL. 40% assoc w/ other injury to knee -- consider MRI.
Peds Tibial Eminence Classification system
I: non-displaced
II: anterior displacement w/ post intact
IIIA: only ACL insertion completely displaced
IIIB: entire eminence completely displaced
IV: Comminuted & displaced
TX Type I tibial eminence fx:
non-op: cast/brace in extension(allows compression of the eminence by the condyles) upto 20 degrees of flexion
TX Type II tibial eminence fx:
if can get reduced with extension then non-op. . .if displaces anteriorly then need to tx operatively b/c will result in extension block
TX Type III & IV tibial eminence fx:
arthroscopic or open reduction and tx -- ant horn med or lat meniscus or intermeniscal ligament can prevent reduction: suture fixation or screw fixation techniques acceptable
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