Objective
To investigate the prevalence and combinations of PCL injuries and their correlations with the mechanism, the occurrence of evident dislocation and associated fracture.
Method
A retrospective study of 85 lesions of PCL operated between 2003 and 2010. Diagnosis by physical examination and dynamic radiography, compared with surgical findings.
Results
Injuries involving the PCL were more prevalent in men (78.8%) with a mean age of 33 years. The main cause was traffic accidents (73.80%), and (49.4%) motorcycle. Isolated PCL injury occurred in (15.3%) cases, and combined (84.7%). Among the isolated lesions, bone avulsions were nine (10.6%). The most associated PCL injuries were the ACL (48.2%), followed by LCL PCL/PLC (22.4%). Fractures were more associated with combining PCL + LCL/PLC injuries and did not appear in the PCL + MCL/PMC. Complications beyond fractures: peripheral nerve injury (4.8%) and vascular (1.2%). Evident dislocation in primary care (16.7%) was more prevalent in combined ACL + PCL + MCL/PMC (44.4%). Half the patients were operated during the acute phase. There was a statistically significant difference (
p
< 0.05) comparing each combination of ligament injuries with the presence of fracture, dislocation or clear mechanism of injury.
Conclusion
Surgical treatment of PCL injuries in a center for orthopedic trauma care was mostly multiligament and mainly involving the ACL. A significant association was seen between the type of injury with mechanism of injury, presentation of the knee, if dislocated or reduced, and the presence of associated fracture.
The authors report a case of simultaneous bilateral rupture of the patellar ligament resulting of low-energy trauma in a patient with chronic renal failure.
Objective
With the objective of identifying the incidence of ipsilateral knee ligament injury, thirty-six patients with femoral shaft fractures were evaluated.
Methods
During the osteosynthesis procedure to repair the femur while under anesthesia, all patients underwent a physical examination and X-ray examination.
Results
The most common mechanism of injury observed was motorcycle accidents. Of the thirty-six patients that were studied, eleven patients (30.5%) had a knee ligament injury. Of the eleven patients, 64% had a cruciate ligament injury. The ligament injury was not treated at the time of the osteosynthesis procedure.
Conclusion
We highlight the difficulty of diagnosis at the time of admission and the need for systematic physical examination before and after surgical treatment of femoral fracture.
Objective
Review of the literature concerning the subject and to compare the results of the technique we have been using with the ones reported on the literature.
Methods
This is a retrospective, cross-sectional and observational study. We evaluated the records of patients treated surgically at the Hospital from Hospital Maria Amelia Lins January 1997 to January 2011.The following variables were considered: age, gender, side, degree of injury, mechanism of trauma, associated injuries, time elapsed between injury and surgical procedure, complications, range of motion and muscle strength.
Results
Five patients underwent surgical treatment with the use of autograft semitendinosus and gracilis tendons and V-Y quadricepsplasty. Regarding gender, there was a male predominance (80%). The average age was 35.2 years old. The right side was the most affected (60%). The predominant mechanism of injury was motorcycle accident (80%). All patients had a complete tendon lesion. Time between injury and surgery averaged 10.4 months. Four patients (80%) had had associated injuries. In all patients muscle strength was satisfactory (M4/M5). Wound dehiscence was observed in 01 patient. Average postoperative range of motion was 110°.
Conclusions
These are rare lesions. Stretching the quadriceps is essential to decrease the tension to the reconstructed patellar ligament and patellofemoral joint. Use of a quadriceps transtendon tunnel is an option to prevent fractures. Hypotrophy of the quadriceps is inevitable, however, the resulting force is sufficient for daily living activities.
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