1 Principles topenlarge
Choice of fixation technique
Suturing is the best alternative to screw fixation if the avulsion fragment is small or comminuted.
Avulsion of anterior cruciate ligament
The A1.3-type injury represents an avulsion of the anterior cruciate ligament.
This intraarticular avulsion fracture is most often seen in the younger patient.
2 Reduction topenlarge
The fracture is visualized with the arthroscope and reduction is attempted with a hook or another instrument inserted through another portal.
In open procedures, the avulsed bony fragment of the intercondylar eminence is addressed directly and may be reduced with the help of clamps or wires.