Management of posterior cruciate ligament avulsion by cannulated screw fixation

Lamichhane, A; Mahara, Deepak Prakash

doi:10.3126/joim.v34i3.8914

Cited by 3 publications

(5 citation statements)

References 4 publications

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“…Ten studies utilized the Lysholm scoring system, with 4 comparing pre- and postoperative means. 8-10,17,20,22,30-32,39 In acutely treated knees in 3 studies, the mean Lysholm score improved from 35.4 preoperatively to 94.8 postoperatively. In the sole study examining only chronic PCL tibial avulsion injuries, Singla et al 32 demonstrated that the mean Lysholm score improved from 82 preoperatively to 92 postoperatively.…”

Section: Resultsmentioning

confidence: 99%

“…Overall in 9 studies, the postoperative Lysholm score averaged 92.8. 8-10,17,20,22,30,32,39 While not listing specific scores, Seitz et al 31 did show that 26 of 26 patients had postoperative Lysholm scores >91. Eight studies reported scores via the IKDC.…”

Section: Resultsmentioning

confidence: 99%

“…27,31,40 Posterior knee translation was measured postoperatively as well, with 186 of 212 patients (87.7%) having a negative or grade 1 posterior drawer test. 4,8,9,18,19,22,28,30-32…”

Section: Resultsmentioning

confidence: 99%

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Management of Posterior Cruciate Ligament Tibial Avulsion Injuries: A Systematic Review

et al. 2017

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In patients with displaced tibial-sided PCL avulsion fractures treated operatively, surgical approaches render similar outcomes and risks. While the arthroscopic group had somewhat higher subjective and objective knee outcome scores, it demonstrated a slightly higher rate of arthrofibrosis. The clear advantage of the arthroscopic approach is that concomitant intra-articular injuries seen on preoperative magnetic resonance imaging, such as meniscal tears or osteochondral loose fragments, can be addressed at the time of the index operation.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Management of Posterior Cruciate Ligament Tibial Avulsion Injuries: A Systematic Review

et al. 2017

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“…This approach is difficult in obese and muscular patients; in addition, since the exposure of the lateral base of the PCL is limited, insertion of the screw perpendicular to the fracture line is not always feasible, because it may compromise the stability of the fixation. Most authors 10,[21][22][23] prefer this incision over the former because it is less invasive and it does not expose the neurovascular structures. We used the minimally-invasive approach described by Frosch et al 19 for the last 12 patients in our series.…”

Section: Discussionmentioning

confidence: 99%

Fracturas avulsivas tibiales del ligamento cruzado posterior fijadas con tornillos: Un estudio clínico y radiológico

Schmidt-Hebbel

Reyes

O'Connel

et al. 2021

Revista Chilena de Ortopedia y Traumatología

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Resumen Objetivo Realizar la evaluación clínica, imagenológica y funcional de pacientes con fracturas avulsivas tibiales del ligamento cruzado posterior (FTALCPs) fijadas con tornillos canulados con técnica abierta. Métodos Los pacientes con FTALCP operados entre 2010 y 2017 fueron revisados retrospectivamente. Criterios de inclusión: fracturas agudas, desplazadas, test de cajón posterior grado III, lesiones combinadas de rodilla, seguimiento > 12 meses. Se excluyeron pacientes > 65 años, con FTALCPs bilaterales, lesiones del ligamento cruzado posterior (LCP) intrasustancia, test de cajón posterior grados I-II, fracturas expuestas, lesiones neurovasculares, y seguimientos < 12 meses. Objetivo primario: medir la estabilidad clínica mediante test de cajón posterior y radiografía de estrés arrodillada comparativa. Objetivos secundarios: nvaluar la consolidación en radiografías, complicaciones y funcionalidad con las escalas de Lysholm y Tegner. Resultados Se incluyeron 20 pacientes, con edad media de 41 años (rango: 32 a 61 años). El seguimiento promedio fue de 33,9 meses (rango: 12 a 82 meses). La estabilidad clínica mejoró en 93% (cajón posterior postoperatorio grados 0 y I) de los pacientes. La radiografía de estrés arrodillada mostró una diferencia promedio de 2,6 mm (rango: 0,1 mm a 6,8 mm) de traslación posterior al comparar con el lado sano. Todas las fracturas consolidaron. Siete pacientes presentaron complicaciones. El puntaje promedio de la escala de Lysholm al final del seguimiento fue de 85,17. El promedio preoperatorio del puntaje en la escala de Tegner no varió significativamente en comparación con el postoperatorio. Conclusiones La fijación de fracturas avulsivas tibiales del LCP con tornillos canulados con técnica abierta es efectiva en restaurar la estabilidad posterior y lograr la consolidación ósea. La funcionalidad clínica a mediano plazo es buena, a pesar del alto número de complicaciones y lesiones concomitantes.Nivel de evidencia tipo IV.

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“…Many reports showed that posteromedial approach is fairly easy, safe, time saving, and associated with less morbidity [9][10][11][12].…”

Section: Discussionmentioning

confidence: 99%

Posteromedial Approach to Fix Posterior Cruciate Ligament Tibial Avulsion: A Backup Fixation and Case Series

Elhadi¹,

Mohd²,

Waleed³

et al. 2021

J Orthop Surg Tech

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Background and purpose: Tibial avulsion fractures of PCL are common; however, the choice between open reduction internal fixation (ORIF) and arthroscopic repair of acute fractures remains controversial. We assessed the efficacy and safety of managing PCL avulsion fractures with ORIF using the posteromedial approach.Methods: This series includes 10 patients (9 males and one female) with a median age of 36 years (range 23-48 years) who underwent ORIF with a posteromedial approach for PCL avulsion fractures, with and without other knee ligamentous injuries. Bony fragments were fixed using cortical screw with a washer augmented with another backup screw fixed 3-5 cm distally. Postoperatively, the mean follow-up time was 18.8 months (range 3.5-48 months). All the surgeries were performed at a mean of 75 days (range 1-600 days) of injury, and clinical and radiological assessments were also used. Results:The patients achieved fracture union an average of 14 weeks postoperatively (range: 8-24 weeks). Two patients who sustained other ligamentous injuries demonstrated residual disability. Patients returned to work (heavy labour) within 6 months postoperatively (range: 4-9 months). Conclusion:The posteromedial approach is safe, time saving, and was not associated with complications. This approach provides stable fixation with no residual knee laxity and can be used to manage posteromedial fractures of the medial femoral condyle and tibial plateau. Further high quality studies are needed to assess this surgical approach.

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Management of posterior cruciate ligament avulsion by cannulated screw fixation

Cited by 3 publications

References 4 publications

Management of Posterior Cruciate Ligament Tibial Avulsion Injuries: A Systematic Review

Management of Posterior Cruciate Ligament Tibial Avulsion Injuries: A Systematic Review

Fracturas avulsivas tibiales del ligamento cruzado posterior fijadas con tornillos: Un estudio clínico y radiológico

Posteromedial Approach to Fix Posterior Cruciate Ligament Tibial Avulsion: A Backup Fixation and Case Series

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