Die Apple-Bite-Fraktur – wann und wie versorgen?

Posterolateral impression fractures of the tibia are a frequent comorbidity of ruptures of the anterior cruciate ligament (ACL). Because of the morphological appearance, the term “apple bite fracture” has become established. These fractures are often associated with additional injuries of the lateral meniscus and the medial ligament complex and, depending on the severity, are an independent risk factor for inferior postoperative results after ACL reconstruction. The recommendation for a surgical intervention depends on the depth of the bony impaction and the extent of the fracture. Most fractures which require surgery can be addressed by a minimally invasive procedure with arthroscopic assistance, for which in particular retrograde elevation followed by percutaneous screw fixation in the jail technique has become established. The clinical results show promise, however, valid scientific data regarding clear indications for surgical treatment of apple bite fractures are still missing.