Page 124 - DOS Kongressen 2012 - Abstracts

84.
TIBIAL AVULSION FRACTURE OF THE POSTERIOR ROOT OF
THE MEDIAL MENISCUS IN CHILDREN AFTER MINOR TRAUMA
Jonas Vestergård Iversen, Michael Rindom Krogsgaard
Section for Sportstraumatology, M51. Department of Orthopaedic Surgery
Bispebjerg University Hospital; Section for Sportstraumatology, M51.
Department of Orthopaedic Surgery, Bispebjerg University Hospital
Background:
Background: The circular collagen fibers, which are crucial for
the load absorption, that is one of the important functions of the meniscus, are
rooted onto tibia anteriorly and posteriorly. If one of these roots is detached
from tibia, the circular fibers loosen, leading to meniscus extrusion and
reduction of the load absorptive properties of the meniscus, which may
increase the risk of degenerative osteoarthritis. Therefore, avulsion fractures of
the meniscal roots are important to diagnose, even though they are rare. They
can be part of larger injuries to the knee or isolated ruptures after minor
trauma.
Purpose / Aim of Study:
Purpose/aim: To report two cases of a displaced
avulsion fracture of the posterior root of the medial meniscus (AFMMPR) in
children, treated at the same institution during a one year period.
Materials and Methods:
Material and methods: The patients were a 12 year-
old boy and a 13 year-old girl. They were diagnosed with AFMMPR after
minor traumatic events during sports. X-rays, MRI-scans, operative
documentation and post-operative follow-up was available.
Findings / Results:
Results: The root avulsion was overlooked on x- rays in
one case, and was not acknowledged on a following MRI and was diagnosed
during arthroscopy for knee locking. In the other case, the avulsion was not
obvious on x-rays but was diagnosed on MRI. After arthroscopic confirmation
the avulsions were reattached in both cases with internal fixation by trans-tibial
pull-out sutures. At six weeks the boy had locking after a new trauma and was
re-scoped – the avulsion had healed. Both patients had no complaints at
follow-up.
Conclusions:
Conclusion: It is not always easy to diagnose root avulsions. The
typical presentations on x- rays and MRI are discussed. Few reports have
described AFMMPR in skeletally immature patients, but our cases were
treated successfully with arthroscopic reattachment. As stability of the circular
fibers of the menisci are essential for load absorption, it is important not to
overlook root avulsions.