Simple and safe arthroscopic placement and removal of cannulated screw and washer for fixation of tibial avulsion fracture of the anterior cruciate ligament.

Abstract

Avulsion of the tibial insertion of the anterior cruiciate ligament can be managed by arthroscopic reduction and fixation. Anterograde and retrograde fixation with screws has been reported. Anterograde fixation using cannulated screws is technically less demanding and allows for stable fixation even with thin fragments. Additional use of a washer affords safe fixation of comminuted avulsion fractures. Removal of the screw and washer is mandatory but sometimes problematic. A simple and safe technique of arthroscopic placement and removal of a screw and washer used for fixation of an avulsion fracture of the tibial insertion of the anterior cruiciate ligament is presented. The same technique can be used for placement and removal of a cannulated screw and washer used in other joints.