Avulsion fracture of the posterior cruciate ligament at the tibial insertion in a child: a case report

Uğutmen, Ender; Sener, Nadir; Eren, Abdullah; Beksaç, Burak; Altıntaş, Faik

doi:10.1007/s00167-005-0706-x

Cited by 28 publications

(27 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, radiographic analysis is critical for proper diagnosis and treatment. Plain radiographs can be useful to detect an avulsed fragment if it is mostly osseous [20,22,32,34,36]. However, avulsion cannot be ruled out by unremarkable plain films, especially in skeletally immature patients, as was the case in one of our patients [9,22].…”

Section: Discussionmentioning

confidence: 80%

“…Although clinical findings such as a posterior tibial sag and provocative physical examination maneuvers such as the posterior drawer and quadriceps-active test are hallmarks of PCL insufficiency, no physical examination maneuvers can differentiate a substance tear from an avulsion injury [6,7,11,14,20,32,34,36]. Therefore, radiographic analysis is critical for proper diagnosis and treatment.…”

Section: Discussionmentioning

confidence: 99%

“…If the avulsed fragment is nondisplaced or minimally displaced, nonoperative treatment may be successful with a concentration on quadriceps strengthening [14,32]. If the avulsed fragment is displaced or nonoperative treatment fails, surgical reduction and fixation may be considered [2,14,26,32,36,38]. Controversy exists regarding proper treatment (ie, nonoperative versus operative) for these injuries, particularly since there is a paucity of published material regarding the natural history of PCL insufficiency in the pediatric population.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Pediatric PCL Insufficiency from Tibial Insertion Osteochondral Avulsions

Pandya

Janik

Chan

et al. 2008

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Posterior cruciate ligament (PCL) insertion-site osteochondral avulsions in children, particularly from the tibia, are not commonly seen by orthopaedic surgeons. Because of the rarity of these injuries, careful attention to the specific physical examination and imaging findings seen with these injuries is necessary so that the proper diagnosis can be made. Osteochondral avulsions of the PCL can be missed on plain radiographs in skeletally immature patients, and therefore magnetic resonance imaging is necessary for proper diagnosis. With this knowledge, clinicians can formulate treatment plans which can return their patients to activities while avoiding potential morbidity resulting from missed diagnoses or improper treatment. We report two rare cases of PCL insufficiency stemming from tibial insertion osteochondral avulsions. Both patients underwent subsequent open reduction and internal fixation of the avulsion using two different fixation methods (bioabsorbable anchors versus cannulated screw and washer) and have returned to full sporting activities.

show abstract

Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pediatric PCL Insufficiency from Tibial Insertion Osteochondral Avulsions

Pandya

Janik

Chan

et al. 2008

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…There is evidence to suggest that surgical ORIF should be actively implemented when fracture fragment displacement is more than 1 cm or when conservative treatment has failed. (12,13) The current surgical options for PCL avulsion fractures of the tibia include arthroscopic repair and ORIF. First reported in 1995, arthroscopic treatment of tibial avulsion fractures has since received much attention with the progress of arthroscopic techniques.…”

Section: Discussionmentioning

confidence: 99%

Treatment of posterior cruciate ligament avulsion fractures of the tibia using a toothed plate and hollow lag screw

Chen¹,

Luo²,

Chen³

et al. 2016

smedj

View full text Add to dashboard Cite

INTRODUCTIONTo investigate the feasibility and clinical efficacy of using a toothed plate and hollow lag screw in the surgical treatment of posterior cruciate ligament (PCL) avulsion fractures of the tibia. METHODSA total of 21 patients were treated with open reduction and internal fixation using a toothed plate and hollow lag screw, through a posteromedial approach using an inverted L-shaped incision. The patients were allowed appropriate functional exercises, including knee flexion and extension, after removal of the plaster at postoperative weeks 3-6. The follow-up period was between six months and two years. RESULTSThis was a retrospective study of patients with PCL avulsion fractures of the tibia caused by road traffic accidents (n = 9), sports-related injuries (n = 6), falls (n = 5) and machinery-related injuries (n = 1). 20 patients presented with fresh fractures and one with an old fracture. The patients (13 men, eight women) had a mean age of 41.5 (range 19-72) years. Anatomical reduction of the fracture and satisfactory fixation were achieved in all 21 patients. Bony union was achieved in all patients at 8-12 weeks after surgery. Six months after surgery, knee flexion was 121.9° ± 10.4° and extension was 0°. According to the Lysholm Knee Scoring Scale, 19 patients were rated as 'excellent' and two as 'good'. CONCLUSIONThe use of a toothed plate and hollow lag screw could be a simple and reliable approach for PCL avulsion fractures of the tibia. Patients achieved good knee function after surgery.

show abstract

“…1 These injuries have included both "peel-off" and avulsion patterns in the femur, 2,3 midsubstance injuries, 4 and injuries of the tibial attachment. 5 Several authors have suggested that midsubstance injuries are much less common than femoral origin or tibial attachment injuries. 1 Treatment of PCL injuries remains controversial in patients with open physes.…”

mentioning

confidence: 99%

Volumetric Damage to the Femoral Physis During Double-Bundle Posterior Cruciate Ligament Reconstruction: A Magnetic Resonance Imaging Computer Modeling Study

Shea

Grimm

Nichols

et al. 2015

Arthroscopy: The Journal of Arthroscopic & Related Surgery

View full text Add to dashboard Cite

Avulsion fracture of the posterior cruciate ligament at the tibial insertion in a child: a case report

Abstract: The posterior cruciate ligament (PCL) avulsion fracture from its tibial insertion is a very rare condition in children. An isolated avulsion fracture of PCL in a child and its repair by open reduction and internal fixation with a screw is reported.

Cited by 28 publications

References 5 publications

Pediatric PCL Insufficiency from Tibial Insertion Osteochondral Avulsions

Pediatric PCL Insufficiency from Tibial Insertion Osteochondral Avulsions

Treatment of posterior cruciate ligament avulsion fractures of the tibia using a toothed plate and hollow lag screw

Volumetric Damage to the Femoral Physis During Double-Bundle Posterior Cruciate Ligament Reconstruction: A Magnetic Resonance Imaging Computer Modeling Study

Contact Info

Product

Resources

About