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By Robert E. Hunter

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AANA ADVANCED ARTHROSCOPY: THE KNEE 18 ● ● ● ● Hold reduction with a Steinmann pin placed percutaneously from a medial parapatellar position; use fluoroscopy. Suture fixation is the preferred method in the skeletally immature and with comminuted or small fragments. 5-mm) cannula for suture passage will eliminate the chance of entrapping subcutaneous and capsule tissues. 4-mm guide pin, make a small longitudinal incision between the two guide pin puncture wounds, retrieve all sutures through this incision, and tie each suture individually.

2 high-strength suture. The high-strength suture is pulled back through the ligament fibers and out through the skin and accessory portal. An ACL guide is used to placed medial and lateral drill holes to pull the ends of the suture and fragment down into Grasper Suture lasso FIGURE 3-9 A 90-degree suture lasso is placed through the fibers of the ACL. The wire loop within the lasso is secured with an arthroscopic grasper. (Adapted from Lubowitz, J, Elson, W, Guttmann, D. Part II: Arthroscopic treatment of tibial plateau fractures: intercondylar eminence avulsion fracture.

From Chan Y, Chiu, C, Lo Y, et al. Arthroscopy-assisted surgery for tibial plateau fractures: 2- to 10-year follow-up results. Arthroscopy. 2008;24:760-768. Chapter 3 Arthroscopic Management of Tibial Plateau Fractures A B C 25 D FIGURE 3-8 A, Only two longitudinal wounds appear on either side of the leg postoperatively. No knee arthrotomy or extensive soft tissue dissection was performed in the patient. B, C, Plain radiographs showed solid bone union with normal alignment (anteroposterior and lateral views).

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AANA Advanced Arthroscopy. The Knee by Robert E. Hunter


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