Functional evaluation of fixation for PCL bony avulsion fractures using Burk and Schaffer’s approach

Abstract

Floating Knee is the term applied to the flail knee joint segment resulting from a fracture of the shaft or adjacent metaphysis of the ipsilateral femur and tibia The fractures range from simple diaphyseal to complex articular types. The word floating knee was introduced for the first time by Mc Bryde in 1965. The incidence of these injuries is increasing. They are associated with potentially life threatening injuries of the head, chest, and abdomen. Not less frequently these injuries cause infection, excessive blood loss, fat embolism, mal union, delayed or non-union, knee stiffness, prolonged hospitalization, and inability to bear weight. Malunion is one complication which drastically affects the functional outcome. Hence we tried to find the factors that may result in malunion more often than not which will help to prepare us in a more suitable manner in treating these injuries We analysed 30 cases of floating knee which were surgically treated regarding the pattern of injuries, type of injuries, closed/open, fixation methods, associated injuries, union rates, malunion and functional outcome. All cases were followed up to a minimum of 1 year. We found that malunion in a floating knee injury which was surgically treated drastically affected functional outcome. The mechanism of injury, type of fracture, open/closed injury, level of fracture whether diaphyseal or juxta articular or intraarticular, type of initial fixation all had a significant correlation with occurrence of malunion.

Functional outcome of posterior cruciate ligament avulsion injuries treated with open reduction and cannulated cancellous screw fixation

“…The Posterior Cruciate Ligament (PCL) is the main posterior stabilizer of the knee and limits posterior tibial translation [1] . The PCL also plays a role as a central axis controlling and imparting rotational stability to the knee.…”

“…The most effective management of PCL injuries remains unclear and the natural history of untreated PCL injuries is controversial. Isolated bony posterior cruciate ligament (PCL) avulsion fractures are infrequent, estimated to account for 3% -20% of knee ligament injuries [1,2] . Tibial-sided PCL avulsion fractures are the most common form of isolated bony PCL disruption [3] .…”