Introduction Avulsion fracture of the intercondylar eminence at the in- sertion of the anterior cruciate ligament (ACL) is the bony equivalent of a ligamentous rupture. This mode of ACL failure is mostly seen in children and adolescents [1]. However, these fractures are observed with increasing fre- quency in adults [6, 8, 16, 17]. Satisfactory reduction is essential to prevent nonunion or malunion of a fracture, which in turn can cause persistent problems such as knee pain, loss of extension, and laxity of the ACL [9, 12, 22]. The management of fractures is uncomplicated and straightforward when they are minimally displaced. How- ever, the treatment of displaced and complete separation fractures has been controversial, and there is no common agreement about reduction and fixations of these frac- tures. The various modes of reduction and fixation pro- posed for these fractures have generally resulted in con- siderable morbidity [8, 17, 18, 22]. The application of arthroscopic techniques to fracture treatment has ex- panded during the past decade, but these modes of treat- ment are not without limits, which are related to technical difficulty and unstable fixation [3, 9, 11, 13, 15, 19, 20]. This report describes a new technique of arthroscopic reduction and antegrade cannulated screw fixation of dis- placed intercondylar eminence of tibia fractures. Materials and methods Twelve patients were reviewed who underwent arthroscopic fixa- tion of displaced tibial spine fracture at our department between February 1995 and February 1998. Ten were children (9–14 years old), one an adolescent (17 years old), and one an adult (21 years old; mean age 14 years and 3 months). Seven were male and five were female. The left knee was involved in seven and the right in five. All of the patients had a fresh injury and were seen within 10 days after the trauma. Routine radiography of the knees showed the fractures of the intercondylar eminence of the tibias; these were classified according to the system proposed by Myers and McKeever [16, 17], which is a three-type classification scheme based on the degree of fracture displacement. Type III (n=7) and unreduced type II (n=5) fractures of the intercondylar eminence were reduced and fixated with antegrade cannulated screws by us- ing a new arthroscopic technique. Abstract We describe a new tech- nique for arthroscopic reduction and internal fixation of fractures of the intercondylar eminence of the tibia. In this technique cannulated screws are placed through a new portal (transquadricipital tendinous) instead of anteromedial arthroscopic portal. Twelve patients who were treated with this technique for displaced types II and III fractures of the intercondylar eminence of the tibia were reviewed after a mean of 49 months. At fol- low-up all patients had excellent or good results, without any case of nonunion of the fracture or related complications, such as functional in- stability. Placement of cannulated screws through transquadricipital tendinous portal achieves fragment reduction easily, provides rigid fixa- tion while avoiding arthrotomy, al- lowing early mobilization and return to activity. Keywords Fracture · Intercondylar eminence · Arthroscopy · Technique · Fixation KNEE Knee Surg, Sports Traumatol, Arthrosc (2001) 9 : 346–349 DOI 10.1007/s001670100235 M. Nedim Doral Ö. Ahmet Atay Gürsel Leblebiciog ˘lu Onur Tetik Arthroscopic fixation of the fractures of the intercondylar eminence via transquadricipital tendinous portal Received: 5 February 2001 Accepted: 25 May 2001 Published online: 26 July 2001 © Springer-Verlag 2001 M.N. Doral (✉) · Ö.A. Atay · G. Leblebiciog ˘lu · O. Tetik Departments of Orthopaedics and Traumatology, Hacettepe University Medical Center, 06100 Ankara, Turkey e-mail: mn-doral@bi.net.tr, Tel.: +90-312-305 1793, Fax: +90-312-490 5133