Abstract:
Displaced tibial eminence fractures in adults are uncommon injuries, often associated with concomitant soft tissue damage, including meniscal root tears, meniscal entrapment, and ligamentous stretch. Management options include arthroscopic reduction and internal fixation (ARIF) or open reduction and internal fixation (ORIF). ARIF allows direct visualization of the fracture, re-tensioning of the anterior cruciate ligament (ACL), and simultaneous management of soft tissue injuries. Suture fixation through ARIF avoids reliance on small bony fragments, reduces hardware removal rates, and may better restore knee stability, though evidence remains limited to Level III–IV studies. Conversely, ORIF is technically easier, quicker, and more accessible for general orthopedic surgeons, with comparable clinical outcomes reported in retrospective studies, despite a higher risk of screw removal. Modern imaging with CT and MRI is critical for identifying associated injuries and guiding treatment. The choice of technique should consider fracture morphology, soft tissue involvement, and surgeon expertise, with consultation from arthroscopic specialists recommended for complex cases.