Avulsion fracture of the posterior oblique ligament associated with acute tear of the medial collateral ligament

Kuroda, Ryosuke; Muratsu, Hirotsugu; Harada, Toshihiko; Hino, Takayoshi; Takayama, Hiroyuki; Miwa, Masahiko; Sakai, Heiichi; Yoshiya, Shinichi; Kurosaka, Masahiro

doi:10.1053/jars.2003.50069

Cited by 18 publications

(8 citation statements)

References 12 publications

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“…“Peel-off” injuries of the POL can be addressed with suture-anchor fixation. 25 Large implants should be avoided and the fixation should be stable enough to allow early range of motion exercises.…”

Section: Indications For Acute Medial Surgerymentioning

confidence: 99%

Surgical treatment of medial knee ligament injuries: current indications and techniques

Tandoğan

Kayaalp

2016

EFORT Open Reviews

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The medial collateral ligament (MCL) and the posterior oblique ligament (POL) are the main static valgus restraints of the knee.Most isolated medial injuries can be treated with bracing and early knee motion.Combined MCL and ACL (anterior cruciate ligament) injuries can be managed with bracing of the knee followed by a delayed reconstruction of the ACL.Residual medial laxity may be addressed at the time of ACL surgery.Bony avulsions, incarceration of the distal MCL under the meniscus or over the pes anserinus tendons, open injuries, MCL tears combined with PCL or bi-cruciate injuries should be treated surgically.Chronic symptomatic medial instability can be managed with the recently described reconstruction techniques using free tendon grafts located at anatomical insertion sites.

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Section: Indications For Acute Medial Surgerymentioning

confidence: 99%

Surgical treatment of medial knee ligament injuries: current indications and techniques

Tandoğan

Kayaalp

2016

EFORT Open Reviews

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“…Posterolateral knee dislocation vastus medialis) between the femoral condyles has been reported (27). There is still no consensus as to the best surgical method, and treatment options range from arthroscopic debridement of the capsule-ligament structures (28) to open reduction and removal of the muscle interposition (14,(29)(30)(31). In cases of muscle dislocation different surgical choices are advocated: sectioning of the muscle to allow reduction of the knee dislocation (27) or repair of the muscle rupture to return the muscle to its anatomical site (29).…”

Section: J Ointsmentioning

confidence: 99%

Irreducible posterolateral dislocation of the knee: a case report

Solarino¹,

Notarnicola²,

Maccagnano³

et al. 2015

Joints

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Irreducible posterolateral dislocations of the knee are rare lesions, generally caused by high-energy trauma inducing rotational stress and a posterior and lateral displacement of the tibia. In these conditions, the interposition of abundant soft tissue inside the enlarged medial joint space prevents spontaneous reduction or non-surgical treatment by manipulation of the dislocation. Surgical treatment is therefore compulsory. We report the clinical case of a woman who suffered a subluxation of the knee while jogging. The case we describe is of interest because it shows that even less severe knee dislocations, like this subluxation caused by a low-velocity sports trauma, may present in an irreducible form requiring open surgery. Clinicalinstrumental monitoring did not reveal any signs of vascular or nerve injury. Owing to the irreducibility of the lesion we were obliged to perform open surgery in order to free the joint from the interposed muscle tissue and repair medial capsule-ligament lesions. Repair of the damaged cruciate ligaments was deferred to a second stage, but ultimately rendered necessary by the persistence of joint instability and the need to address the patient's functional needs. In the literature, different one-and two-step surgical options, performed by arthroscopy or arthrotomy, are reported for such related problems. The Authors discuss these various options and examine and discuss their own decision taken during the surgical work-up of this case.Key Words: knee, posterolateral, dislocation, anterior cruciate ligament, injury. IntroductionDislocation of the knee is a rare orthopaedic emergency that requires appropriate monitoring and treatment. It has a low estimated annual incidence, accounting for less than 0.01% of trauma episodes, even if the true number of cases is unknown because many dislocations reduce spontaneously already at the site of the traumatic event (1). Most lesions of this kind are caused by high-velocity sports traumas (2), in which traumatic forces produce stress in the sagittal plane of the knee in the anteroposterior direction and in the frontal plane in varus-valgus angulation (3), inducing a rotational dislocation of the tibia in relation to the femoral condyles. This causes lesions of the ligament structures, also involving the popliteal artery in 20% of cases and the common peroneal or tibial nerve in 19% (4). In the literature, the role of non-surgical "closed" reduction is emphasized (5), while surgical treatment should be reserved for irreducible cases or those in which vesselnerve complications arise or there are signs of immediate joint instability (6). Case reportA healthy 51-year-old woman suffered a traumatic sprain of her left knee when she fell while jogging. Unable to stand or walk, she was immediately transfer-

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“…Avulsion fractures of the POL femoral end are rare. When we searched PUBMED, NCBI, and CNKI databases, we only found a document on POL femoral avulsion fractures 6 . In this study, they repaired MCL injury and POL femoral avulsion fracture through onestage repair.…”

Section: Discussionmentioning

confidence: 99%

“…Some clinicians think that POL is not an independent anatomical structure and, therefore, pay insufficient attention to it. However, some studies have shown that in patients with MCL injury and POL injury, only repairing the MCL without treating the POL injury often fails to reconstruct the stability of the knee joint 6 . Therefore, repair or reconstruction after experiencing a POL injury is necessary.…”

Section: Introductionmentioning

confidence: 99%

One‐Stage Repair of Posterior Oblique Ligament Avulsion Fracture Combined with Medial Collateral Ligament Injury

Zhang

et al. 2020

Orthopaedic Surgery

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Objective To evaluate the clinical effect of the one‐stage repair of a posterior oblique ligament avulsion fracture combined with a medial collateral ligament injury. Methods This study was a retrospective trial. From February 2007 to May 2017, five patients with posterior oblique ligament avulsion fracture combined with medial collateral ligament injury were included in this study. The patients were aged 37–58 years old with a mean of 45.2 years. All patients underwent the primary repair of a posterior oblique ligament avulsion fracture and medial collateral ligament injury. The main observational index included Lysholm score, International Knee Documentation Committee (IKDC) score, Visual Analogue Scale (VAS) score, and range of motion (ROM). Results The results showed that the average time of follow‐up was 53.6 months (range, 20–86 months). When compared to preoperative scores, the preoperative Lysholm score was significantly increased (47.8 ± 5.1 vs 95.0 ± 3.7, P < 0.05), the IKDC score was significantly increased (51.2 ± 5.6 vs 88.6 ± 4.2, P < 0.05), the VAS score was significantly decreased (7.0 ± 0.7 vs 0.4 ± 0.5, P < 0.05), and the ROM was significantly increased (91.6° ± 8.4° vs 129.9° ± 4.4°, P < 0.05). Conclusion Our study found that with the combination of the one‐stage repair of a posterior oblique ligament (POL) avulsion fracture and medial collateral ligament injury, the patient's postoperative function recovered well, their pain was relieved, and their knee joint stability was reliable.

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Avulsion fracture of the posterior oblique ligament associated with acute tear of the medial collateral ligament

Cited by 18 publications

References 12 publications

Surgical treatment of medial knee ligament injuries: current indications and techniques

Surgical treatment of medial knee ligament injuries: current indications and techniques

Irreducible posterolateral dislocation of the knee: a case report

One‐Stage Repair of Posterior Oblique Ligament Avulsion Fracture Combined with Medial Collateral Ligament Injury

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