Biomechanical Properties of Different Fixation Techniques for Posterior Cruciate Ligament Avulsion Fractures

Domnick, Christoph; Kösters, Clemens; Franke, Friederike; Raschke, Michael J.; Petersen, Wolf; Fink, Christian; Herbort, Mirco

doi:10.1016/j.arthro.2015.10.013

Cited by 30 publications

(22 citation statements)

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“…Both arthroscopic and open techniques have been used to fix the avulsed PCL fragment depending upon the expertise of the surgeon, but literature is limited suggesting the superiority of one method over the other. [12][13][14] Arthroscopic PCL fixation is technically challenging, could be time consuming and difficult with a steep learning curve. In addition, arthroscopically it is often difficult to achieve accurate reduction of the widely displaced comminuted fragment.…”

Section: Discussionmentioning

confidence: 99%

Management of comminuted tibial end bony avulsion of posterior cruciate ligament by open posterior approach using suture bridge technique: A case series

Pandey

Mathai

Varshini

et al. 2017

Journal of Clinical Orthopaedics and Trauma

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Section: Discussionmentioning

confidence: 99%

Management of comminuted tibial end bony avulsion of posterior cruciate ligament by open posterior approach using suture bridge technique: A case series

Pandey

Mathai

Varshini

et al. 2017

Journal of Clinical Orthopaedics and Trauma

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“…However, avulsions of the posterior cruciate ligament often involve larger fragments. 23 Although minimally invasive arthroscopic approaches to these fractures have been reported, 24 in cases of a dislocated fragment, the minimally invasive anterograde popliteal approach, which is a modified posteromedial approach with a smaller incision, 25 may enable better reduction of the fragment under direct vision. When incising the dorsal capsule, care must be taken not to injure the posterior cruciate ligament.…”

Section: Treatment Options: Approaches and Techniquesmentioning

confidence: 99%

Partial proximal tibia fractures

2017

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Partial tibial plateau fractures may occur as a consequence of either valgus or varus trauma combined with a rotational and axial compression component.High-energy trauma may result in a more complex and multi-fragmented fracture pattern, which occurs predominantly in young people. Conversely, a low-energy mechanism may lead to a pure depression fracture in the older population with weaker bone density.Pre-operative classification of these fractures, by Müller AO, Schatzker or novel CT-based methods, helps to understand the fracture pattern and choose the surgical approach and treatment strategy in accordance with estimated bone mineral density and the individual history of each patient.Non-operative treatment may be considered for non-displaced intra-articular fractures of the lateral tibial condyle. Intra-articular joint displacement ⩾ 2 mm, open fractures or fractures of the medial condyle should be reduced and fixed operatively. Autologous, allogenic and synthetic bone substitutes can be used to fill bone defects.A variety of minimally invasive approaches, temporary osteotomies and novel techniques (e.g. arthroscopically assisted reduction or ‘jail-type’ screw osteosynthesis) offer a range of choices for the individual and are potentially less invasive treatments.Rehabilitation protocols should be carefully planned according to the degree of stability achieved by internal fixation, bone mineral density and other patient-specific factors (age, compliance, mobility). To avoid stiffness, early functional mobilisation plays a major role in rehabilitation. In the elderly, low-energy trauma and impression fractures are indicators for the further screening and treatment of osteoporosis.Cite this article: EFORT Open Rev 2017;2. DOI: 10.1302/2058-5241.2.160067. Originally published online at www.efortopenreviews.org

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“…Die verschiedenen Refixationstechniken wurden in biomechanischen Studien gut untersucht [1,3]. Es konnte gezeigt werden, dass Fadencerclagetechniken sowohl eine signifikant höhere maximale Versagenslast als auch eine hö-here Steifigkeit als Refixationen mittels Schraubenosteosynthesen aufweisen [1].…”

Section: Therapieunclassified