Combined anterior cruciate ligament and posterior cruciate ligament tibial avulsion fractures are rare knee injuries that are primarily seen in adults. Prompt surgical intervention is indicated for displaced fractures to restore knee stability. Arthroscopic techniques are now the preferred method for treating anterior tibial spine avulsion fractures with posterior cruciate ligament tibial avulsion fractures being treated arthroscopically or with open reduction and internal fixation methods. This Technical Note and accompanying video demonstrate an arthroscopically assisted repair of bicruciate tibial avulsion fractures using an arthroscopic lever push technique. Two sutures are passed through the anterior cruciate ligament and pulled down through two bone tunnels placed within the tibial fracture bed, and one suture is passed around the posterior cruciate ligament and pulled down through one bone tunnel passing from the anterior tibia to the tibial fracture bed. Our technique is simple and effective in reducing bicruciate tibial avulsion fractures to anatomic position.
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http://dx.doi.org/10.1016/j.eats.2022.04.008 | DOI Listing |
Int J Surg Case Rep
December 2024
Department of Orthopaedics and Traumatology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia, Indonesia.
Introduction: Isolated posterior cruciate ligament (PCL) avulsion fracture is rare in pediatric population. To our knowledge, there is no established guideline to treat this rare injury in children. This case highlights the diagnostic challenges and treatment strategies using screw fixation for such injuries, emphasizing the importance of timely intervention to prevent long-term complications.
View Article and Find Full Text PDFBMC Musculoskelet Disord
December 2024
Division of Orthopaedic and Trauma Surgery, University Hospitals of Geneva, 4 Rue Gabrielle-Perret-Gentil, Geneva, CH-1205, Switzerland.
Purpose: Trochlear dysplasia is found in 3.2% (95% confidence interval (CI) 1.2-6.
View Article and Find Full Text PDFBackground: There is debate regarding nonoperative versus surgical treatment of thumb ulnar collateral ligament (UCL) tears with avulsion fractures. The aim of this study was to evaluate the fragment size in relation to the UCL footprint size in patients with an avulsion fracture injury and to find risk factors associated with surgical treatment.
Methods: In a cohort of avulsion fracture injury patients, the largest side of the fragment was divided by the average reported UCL footprint size (ff-ratio), and a logistic regression was performed to find variables associated with surgery.
JBJS Essent Surg Tech
December 2024
Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut.
Background: For complete disruption of the posterolateral corner (PLC) structures, operative treatment is most commonly advocated, as nonoperative treatment has higher rates of persistent lateral laxity and posttraumatic arthritis. Some studies have shown that acute direct repair results in revision rates upwards of 37% to 40% compared with 6% to 9% for initial reconstruction. In a recent study assessing the outcomes of acute repair of PLC avulsion injuries with 2 to 7 years of follow-up, patients with adequate tissue were shown to have a much lower failure rate than previously documented.
View Article and Find Full Text PDFArthrosc Tech
November 2024
Arthroscopy and Arthroplasty Unit, RNH Hospital, Nagpur, India.
Anterior cruciate ligament avulsion fractures are more commonly seen in children with open physes than in adults. Arthroscopic fixation is considered the gold standard in the management of such injuries. Our technique of anterior-row fixation for these injuries provides various advantages in the form of physeal-sparing, complete anatomic reduction with no anterior beaking, no arthrofibrosis, no residual instability, no intra-articular hardware, no need for a second operation to remove implants, and finally, a full range of movement with no loss of extension.
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