Tibial intercondylar fractures in children: a review of the classification and the treatment of mal-union

Forced flexion with internal rotation of the knee in a child can result in an avulsion fracture of the tibial intercondylar area by the anterior cruciate ligament. Accurate radiological assessment of the size of the fragment is difficult. Conservative treatment with plaster immobilization in 30–50 ° of flexion is recommended for Type I fractures. Operative reduction is suggested for all Type III and some Type II fractures. Correction of mal-union can be achieved by excision of a wedge of tibial bone and reattachment of the origin of the anterior cruciate ligament.