A comparative study of arthroscopic hollow screw fixation and a new suture fixation technique in the treatment of adult tibial intercondylar crest fractures Chen Zhefeng, Department of Bone and Joint, The First Affiliated Hospital of Nanjing Medical University Objective To compare the clinical effects of arthroscopic traditional hollow screw fixation technique and a new suture fixation technique in the treatment of adult tibial intercondylar crest fractures. Methods A retrospective study of adult Meyers III tibial intercondylar anterior crest fractures treated with arthroscopic internal fixation in our department from 2006 to 2012 was conducted, in which a total of 73 patients who received hollow screw fixation (45 patients) and a new suture fixation (28 patients) were included in the study. The diagnosis of all patients was confirmed by radiographs, MRI, and arthroscopic exploration. Exclusion criteria included combined ligament injury and meniscal injury. Patients in the hollow nail group received arthroscopic reduction of the intercondylar crest fracture and one to two 4.0 mm hollow screws, while patients in the new suture group received arthroscopic reduction of the fracture followed by “T” fixation with a No. 5 ETHIBOND wire. The patients in both groups wore adjustable knee braces in the straight position for 4 weeks after surgery, and immediately after surgery, quadriceps isometric training was performed, and partial weight-bearing was allowed on the affected limb, with 0-90° movement of the affected knee from 4 to 6 weeks after surgery, and 0-120° movement of the affected knee from 6 to 8 weeks after surgery. At follow-up, all patients were evaluated at 12 months postoperatively by subjective and objective assessments: subjective assessment was the Lysholm score; objective assessment was the Lachman test and joint mobility measurements. Results Follow-up was obtained for all patients within both groups: 45 patients in the hollow nail group, 25 men and 20 women, with a mean age of 31 years (17-49 years), and 28 patients in the suture group, 17 men and 11 women, with a mean age of 28 years (18-51 years). All patients had radiographs suggestive of bony healing at the time of follow-up. The postoperative scores of the affected knee were scored by the Lysholm scale in both groups, 90.84±7.62 in the hollow nail group and 92.09±4.65 in the suture group, and the scores were compared by independent sample t-test. p=0.462 compared with the postoperative scores in both groups. Lachman test: 45 patients in the hollow nail group had 40 negative, 3 weakly positive, and 2 positive postoperative cases. , 2 positive cases; 20 negative, 6 weakly positive and 2 positive cases in 28 patients in the disability preservation group. The rank sum test was used to compare the two groups, P= 0.2199, and the difference between the two groups was not statistically significant. The hollow nail group had 40 cases of loss of extension ≤2°, 5 cases of 3-5°, and 0 cases of ≥6°, the suture group had 22 cases of loss of extension ≤2°, 4 cases of 3-5°, and 2 cases of ≥6°, P=0.161, the hollow nail group had 41 cases of loss of flexion ≤5°, 4 cases of 6-10°, and 0 cases of ≥11°, and the suture group had 24 cases of loss of flexion ≤5°, 3 cases of 6-10°, and 1 case of ≥11°, P=0.162. Conclusion The use of the No. 5 ETHIBOND suture for the treatment of Meyers III anterior tibial intercondylar crest fractures with “T” through tendon fixation provides similar results as hollow nail fixation, but with lower surgical costs and avoids the pain of secondary internal fixation removal, making it more clinically promising. The procedure is more promising.