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Incarceration of the intermeniscal ligament in tibial eminence injury: a block to closed reduction identified using MRI

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Abstract

Tibial eminence fractures are a relatively uncommon injury, but most frequently occur in children and adolescents with open physes. Entrapment of the intermeniscal ligament or the meniscus itself can occur in the setting of a tibial eminence fracture and when present, poses a significant obstacle to successful closed or surgical reduction. Identification of these entrapped structures on preoperative imaging may be helpful to the physicians caring for these patients and assist with preoperative planning. We present a case of a 13-year-old male who sustained a tibial eminence fracture while playing football. Review by the orthopedic surgeon identified entrapment of the intermeniscal ligament. Subsequently, a closed reduction attempt under anesthesia prior to surgery was unsuccessful and arthroscopy was needed to remove the entrapped intermeniscal ligament and reduce the tibial eminence fracture. Pre-operative knowledge of entrapped soft tissue structures under the fracture plane, particularly the meniscus and intermeniscal ligament, provides the surgeon with valuable insight as to how to best counsel patients on the success of treatment options, how to best prepare for operative treatment, and can guide the surgeon during open reduction to maximize treatment success.

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Conflict of interest

The authors declare they have no conflicts of interest.

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Authors and Affiliations

  1. University of Utah School of Medicine, Salt Lake City, UT, USA

    Noah Archibald-Seiffer, John Jacobs Jr. & Kevin Shea

  2. St. Luke’s Health System, 1109 W. Myrtle, Plaza 1, Suite 200, Boise, ID, USA

    Kevin Shea

  3. University of Cincinnati Department of Radiology, Cincinnati, OH, USA

    Andrew Zbojniewicz

  4. Division of Pediatric Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Andrew Zbojniewicz

  5. St. Luke’s Sports Medicine, Boise, ID, USA

    Kevin Shea

Authors
  1. Noah Archibald-Seiffer
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  2. John Jacobs Jr.
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  3. Andrew Zbojniewicz
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  4. Kevin Shea
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Correspondence to Noah Archibald-Seiffer.

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Archibald-Seiffer, N., Jacobs, J., Zbojniewicz, A. et al. Incarceration of the intermeniscal ligament in tibial eminence injury: a block to closed reduction identified using MRI. Skeletal Radiol 44, 717–721 (2015). https://doi.org/10.1007/s00256-014-2014-3

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  • DOI: https://doi.org/10.1007/s00256-014-2014-3

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