20Jun 2017

OPEN REDUCTION AND INTERNAL FIXATION OF PCL AVULSION FRACTURES USING SPRING PLATE THROUGH MODIFIED POSTERIOR APPROACH.

  • Orthopaedic Department of Sohag University Hospital, Sohag, Egypt.
Crossref Cited-by Linking logo
  • Abstract
  • Keywords
  • References
  • Cite This Article as
  • Corresponding Author

Purpose and hypothesis: To report clinical and functional outcomes following fixation of tibial avulsion fractures of posterior cruciate ligament (PCL) using spring plate through a modified open posterior approach. Methods: This is a retrospective study of 10 patients with displaced PCL tibial avulsion fractures treated acutely by open reduction and internal fixation (ORIF) using spring plate. Hughston`s criteria and knee radiographs were used for clinical assessment. Patients were assessed clinically at 2 weeks, and clinically and radiographically at 6 weeks, 3 months. Results: According to Hughston?s criteria, 9 patients (90%) showed good objective, 8 patients (80%) showed good subjective and 7 patients (70%) showed good functional results. Fair results were seen in 10% (one patient) objective, 20% (2 patients) subjective and 30% (3 patients) functional. There were no poor results. Conclusions:This study supports that displaced avulsion fractures of the PCL should be treated with open reduction and stable internal fixation and introduce a new, stable and cheap method for fixation.

  1. Abbott LC, John B, Saunders M, Bost FC, Anderson CE (1944) Injuries to the ligaments of the knee joint. J Bone Joint Surg 26:503-521
  2. Bali K, Prabhakar S, Saini U, Dhillon M (2012) Open reduction and internal fixation of isolated PCL fossa avulsion fractures. Knee Surg Sports Traumatol Arthrosc 20:315-321
  3. Bianchi M (1983) Acute tears of the posterior cruciate ligament: Clinical study and results of operative treatment in 27 cases. Am J Sports Med 11:308-314
  4. Brenan J (1960) Avulsion injuries of the posterior cruciate ligament. Clin Orthop Relat Res 18:153-163
  5. Burks RT, Schaffer JJ (1990) A simplified approach to the tibial attachment of the posterior cruciate ligament. Clin Orthop Relat Res 254:216-219
  6. Choi N-H, Kim S-J (1997) Arthroscopic reduction and fixation of bony avulsion of the posterior cruciate ligament of the tibia. Arthroscopy 13:759-762
  7. Gwinner C, Kopf S, Hoburg A, Haas NP, Jung TM (2014) Arthroscopic Treatment of Acute Tibial Avulsion Fracture of the Posterior Cruciate Ligament Using the TightRope Fixation Device. Arthroscopy Techniques 3:e377-e382
  8. Hughston J. The posterior cruciate ligament in knee joint stability. Proceedings of the American association of orthopaedic surgeons, January 18?23, New York. J Bone Joint Surg Am 51:1045?1046
  9. Jung TM, H?her J, Weiler A (2006) Screw fixation of a 4 1/2-year-old PCL avulsion injury. Knee Surg Sports Traumatol Arthrosc 14:469-472
  10. Littlejohn SG, Geissler WB (1995) Arthroscopic repair of a posterior cruciate ligament avulsion. Arthroscopy 11:235-238
  11. Logan M, Williams A, Lavelle J, Gedroyc W, Freeman M (2004) The effect of posterior cruciate ligament deficiency on knee kinematics. Am J Sports Med 32:1915-1922
  12. Loos WC, Fox JM, Blazina ME, Del Pizzo W, Friedman MJ (1981) Acute posterior cruciate ligament injuries. Am J Sports Med 9:86-92
  13. Martinez-Moreno J, Blanco-Blanco E (1988) Avulsion Fractures of the Posterior Cruciate Ligament of the Knee: An Experimental Percutaneous Rigid Fixation Technique Under Arthroscopic Control. Clin Orthop Relat Res 237:204-208
  14. Meyers M (1975) Isolated avulsion of the tibial attachment of the posterior cruciate ligament of the knee. J Bone Joint Surg Am 57:669-672
  15. O'Donoghue DH (1950) Surgical treatment of fresh injuries to the major ligaments of the knee. J Bone Joint Surg 32:721-738
  16. Sasaki SU, da Mota e Albuquerque RF, Amatuzzi MM, Pereira CA (2007) Open screw fixation versus arthroscopic suture fixation of tibial posterior cruciate ligament avulsion injuries: a mechanical comparison. Arthroscopy 23:1226-1230
  17. Suprock M, Rogers V (1990) Posterior cruciate avulsion. Orthopedics 13:659-662
  18. Trickey E (1980) Injuries to the posterior cruciate ligament: diagnosis and treatment of early injuries and reconstruction of late instability. Clin Orthop Relat Res 147:76-81
  19. Veselko M, Saciri V (2003) Posterior approach for arthroscopic reduction and antegrade fixation of avulsion fracture of the posterior cruciate ligament from the tibia with cannulated screw and washer. Arthroscopy 19:916-921
  20. Yang C-K, Wu C-D, Chih C-J, Wei K-Y, Su C-C, Tsuang Y-H (2003) Surgical treatment of avulsion fracture of the posterior cruciate ligament and postoperative management. J Trauma 54:516-519.

[Moustafa Elsayed, Mohamed Kenawey, Mohamed Ali and Ashraf Marzouk. (2017); OPEN REDUCTION AND INTERNAL FIXATION OF PCL AVULSION FRACTURES USING SPRING PLATE THROUGH MODIFIED POSTERIOR APPROACH. Int. J. of Adv. Res. 5 (Jun). 1076-1082] (ISSN 2320-5407). www.journalijar.com

Ashraf Marzouk
Orthopaedic Department of Sohag University Hospital, Sohag, Egypt

DOI:

Article DOI: 10.21474/IJAR01/4510      
DOI URL: http://dx.doi.org/10.21474/IJAR01/4510

Download Full Paper

Download PDF No. of Downloads: 52 | No. of Views: 185