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02 May 2022
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Mayer McKeevers II-III paediatric tibial eminence avulsion fracture

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Clinical Details

Clinical and radiological findings:  This is a 12 year old boy who sustained a hyperflexion twisting injury whilst playing soccer. He sustained a Mayer McKeever tibial eminence avulsion fracture the paediatric variant of an ACL tear. Particularly concerning with paediatric avulsions is the underestimation of articular surface involvement given the radio translucency of the thick cartilage surface, and the classical incarceration of the meniscus under the articular flap.

Preoperative Plan

Planning remarks:  place holder

Surgical Discussion

Operative remarks: 

As can be seen by the intra operative arthroscopic images, the medial meniscus was in fact entrapped under the medial fracture extension. This incarceration could be reduced arthroscopically and following debridement of the fracture base, unremarkable arthroscopic reduction was achieved. 2 fibre wire slings around the base of the ACL were brought out in a transosseous fashion and secured over endo buttons on the anterior tibial cortex. One endo button stayed entirely proximal to the physis. The medial button did cross the physis. Both arthroscopic direct visual asses!rt and radiologic confirmation anatomical reduction

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Dr Ed Oates
  • Germany , Schleswig Holstein
  • Area of Specialty - General Trauma
  • Position - Specialist Consultant
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