Fracture of the Intercondylar Eminence of the Tibia

1. Fracture of the intercondylar eminence of the tibia, although not a common fracture, occurs more frequently in children than adults. Its greatest incidence is between the ages of eight and thirteen. See table in the PDF file 2. In children, this fracture occurs as an isolated injury without damage to the other supporting ligaments or gliding surfaces of the knee joint; the prognosis for complete recovery without difficulty is excellent. 3. In adults, fracture of the intercondylar eminence of the tibia is so often accompanied by serious injury to the supporting structures of the knee or other bone injury that serious permanent disability often results. 4. Fractures of the intercondylar eminence of the tibia in children may be divided into three types as demonstrated by roentgenograms: Type I, in which there is no dislodgment of the fragment from its bed of origin; Type II, in which there is partial dislodgment of the fragment, but still good apposition of a large portion of the avulsed fragment; and Type III, in which there is complete dislodgment of the avulsed fragment from its bed and no bone apposition of the fragment. 5. Type I and Type II fractures of the intercondylar eminence of the tibia require only immobilization for a length of time adequate to allow bone union. Open reduction is not indicated in Type I and Type II fractures. 6. Forceful manipulation of the knee into hyperextension with the patient under anaesthesia is not indicated. 7. Type III fracture of the intercondylar eminence of the tibia with complete dislodgmnent of the fragment requires open reduction followed by immobilization. 8. Elaborate metallic internal fixation of the fragment is not required.