Percutaneous Retrograde Extraphyseal screw fixation for Type II and III Anterior Tibial Spine Avulsion Fractures: A Technical Note
Volume 8 | Issue 2 | May-August 2022 | Page: 16-19 | R M Chandak, Mohit Sharma, Amit Nemade
Authors: R M Chandak , Mohit Sharma , Amit Nemade 
 Department of Orthopedics & Trauma, Chandak Nursing Home, Nagpur, Maharashtra, India.
 Department of Orthopedics, Kids Orth Clinic, Nagpur, Maharashtra, India.
Address of Correspondence
Dr. Amit Nemade,
Consultant Pediatric Orthopedic Surgeon, Kids Orth Clinic, Nagpur, Maharashtra, India.
Introduction: Anterior tibial spine avulsion (ATSA) fractures are uncommon intra-articular knee injuries in children. They are common in adolescents. Treatment for displaced ATSA fracture is fixation. Various methods of fixation are documented, most common being arthroscopic assisted fixation using various sutures or anchors. Antegrade screw fixation is also an accepted method of treatment but is associated with implant back out and impingement. We describe our technique of retrograde extraphyseal percutaneous fixation for type II and III ATSA fractures.
Method: Under image intensifier (IITV) guidance, fracture reduction was achieved and fixed with a specially designed, short-threaded, 4mm cannulated screw. The screw was inserted in retrograde fashion proximal to the proximal tibial physis. The patient was immobilized in a cylinder cast and was allowed weight bearing as tolerated. Cast was removed at 6 weeks and range of movement exercises started.
Result: Our technique of percutaneous retrograde extraphyseal screw fixation for ATSA fracture is simple. The learning curve is less and can be used in selected case. In resource-limited situations where facilities for arthroscopy are not readily available, our technique can provide good results
Keywords: Anterior tibial spine avulsion, Percutaneous fixation, Retrograde, extraphyseal.
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|How to Cite this Article: Chandak RM, Sharma M, Nemade A | Percutaneous Retrograde Extraphyseal screw fixation for Type II and III Anterior Tibial Spine Avulsion Fractures: A Technical Note | International Journal of Paediatric Orthopaedics | May-August 2022; 8(2): 16-19. https://doi.org/10.13107/ijpo.2022.v08i02.140|