Objective: This study aimed to evaluate the results of surgical treatment of tibial avulsion injuries of the posterior cruciate ligament (PCL) with a 3.5-mm locking compression hook plate (LCHP).
Methods: From June 2012 to June 2015, 16 consecutive patients (10 males and 6 females, mean age: 38 (range: 19-57) years) presented with isolated tibial avulsion injuries of the PCL. We used a 3.5-mm LCHP and lag screws for open reduction and internal fixation (ORIF) through the posterior medial approach. The operation time, quantity of bleeding, visual analog scale (VAS) scores, stability of posterior drawer test (PDT) results, and fracture healing time were studied to assess clinical efficacy. At the 12-month follow-up, a functional evaluation using knee range of motion (ROM) and the Lysholm knee scoring system (LKSS) was performed.
Results: The data from a mean follow-up of 24.1 (range: 14-33) months from 16 patients were recorded. No neurovascular complications, incision infections, or delayed union or nonunion were observed. The mean operation time was 61.4 (range: 45-80) min. The mean quantity of bleeding was 41.6 (range: 25-66) mL. The mean bone healing time was 11.8 (range: 45-80) weeks. The mean VAS score was 1.63 (range: 0-3) after surgery. The average LKSS and ROM of the knee were 51.75±7.67 and 50.94°±10.19° before surgery and 92.75±5.46 and 127.75°±6.13° at 1 year, respectively. The outcomes were judged to be excellent for 11 patients, good for 4, and fair for 1 (excellent and good rates: 93.8% for 15/16). At the final follow-up (≥1 year), the PDT scores returned to normal.
Conclusion: The results showed that 3.5-mm LCHP provided reliable fixation following ORIF of isolated PCL tibial avulsion fractures and was a safe, simple, and effective procedure. This procedure may reduce complications and improve functional recovery relative to those of other procedures.
Trial Registration: Chinese Clinical Trial Registry, ChiCTR-1900022920. Registered on 3 May 2019.
Level Of Evidence: Level IV, Therapeutic study.
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http://dx.doi.org/10.5152/j.aott.2020.19244 | DOI Listing |
JBJS Case Connect
January 2025
Department of Orthopaedics, PGIMER, Chandigarh, India.
Case: A 30-year-old man presented with left proximal tibia fracture (open Grade 3A) and a transverse lateral malleolus fracture (Weber B) following direct impact injury. Computed tomography revealed a rare posteromedial tubercle fibula fracture at the posterior inferior tibiofibular ligament (PITFL) insertion, with syndesmosis disruption. Initial damage control included an external fixator.
View Article and Find Full Text PDFZhongguo Xiu Fu Chong Jian Wai Ke Za Zhi
January 2025
Department of Orthopedics, the First Affiliated Hospital of Bengbu Medical University, Bengbu Anhui, 233000, P. R. China.
Objective: To analyze the effectiveness of three internal fixation methods, namely hollow screw combined with Kirschner wire tension band, hollow screw combined with anchor nail, and modified 1/3 tubular steel plate, in the treatment of avulsion fracture of tibial tubercle (AFTT) in adolescents.
Methods: Between January 2018 and September 2023, 19 adolescent AFTT patients who met the selection criteria were admitted. According to different internal fixation methods, patients were divided into group A (8 cases, hollow screw combined with Kirschner wire tension band), group B (6 cases, hollow screw combined with anchor nail), and group C (5 cases, modified 1/3 tubular steel plate).
J Pediatr Orthop
January 2025
Departments of Orthopaedic Surgery.
Background: Tibial tubercle fractures (TTF) are uncommon injuries, comprising <3% of proximal tibial fractures. Rarely, they occur in conjunction with patellar tendon avulsion (PTA). We aimed to compare reoperation rates and short-term postoperative outcomes in patients with TTF versus combined injuries.
View Article and Find Full Text PDFJ Orthop Case Rep
January 2025
Department of Orthopaedics, SN Medical College, Agra, Uttar Pradesh, India.
Introduction: Posterior cruciate ligament (PCL) avulsion fractures of the tibia with ipsilateral tibial shaft represent a rare but challenging orthopedic injury, necessitating careful consideration of surgical interventions for optimal outcomes. This case report presents the successful management of tibial shaft fracture (proximal 1/3rd junction) along with ipsilateral PCL avulsion fracture of tibia using a novel approach using open reduction internal fixation (ORIF) of tibial shaft with Locking compression plate (LCP) with cannulated cancellous screw and spiked washer fixation of PCL avulsion. There are no case reports or research articles available for the management of PCL avulsion fracture of tibia associated with ipsilateral tibial shaft fracture.
View Article and Find Full Text PDFEur J Trauma Emerg Surg
January 2025
Department of Orthopaedics, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
Purpose: (1) To evaluate the incidence and combination types of concomitant malleolar and fibular fractures in patients with distal spiral tibial shaft fractures. (2) To evaluate the risk factors for concomitant malleolar fractures in patients with distal spiral tibial shaft fractures.
Methods: A retrospective review was performed on 64 cases of surgically treated distal spiral tibial shaft fractures with complete radiographs and computed tomography (CT) scans.
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