Posterior cruciate ligament tibial insertion avulsion, management by open reduction and internal fixation using plate and screws through a direct posterior approach

Injury ◽  
2020 ◽  
Author(s):  
Ahmed A. Khalifa ◽  
Mohamed Eslam Elsherif ◽  
Essam Elsherif ◽  
Omar Refai
2019 ◽  
Vol 7 (6) ◽  
pp. 982-986
Author(s):  
Navid Salehi ◽  
Faeze Azarifar ◽  
Arman Jahanshahi ◽  
Hamidreza Mohammadi

BACKGROUND: The posterior cruciate ligament is one of the important tissues and structures sustaining the knee joint, and its rupture or detachment may lead to joint instability or destruction. AIM: The present study aimed at investigating the Open Reduction and Internal Fixation surgery of posterior cruciate ligament and comparing it to the normal knee of the same side. METHODS: In this study, 25 patients with avulsion fracture at the PCL joint were treated with open surgery and screw fixation. The patients were followed up by Lysholm knee score for at least 12 months after surgery. RESULTS: All patients were male with an average age of 25 years over the years 2010-2018. The common mechanism of injury in these patients was motorcycle-car accident. In the study with Lysholm knee score, 21 patients (80%) obtained the good score of 60-90 while 20% of patients were placed in the fair group (30-59). The average score was 86. CONCLUSION: The obtained score of knee function questionnaire in this study had no significant difference from other similar studies, and most patients achieved a good and acceptable score after the surgery. There was no knee instability and functional impairment in the patients compared to the normal knee. Considering the clinical results after the fixation of the PCL avulsion fracture causing a significant improvement in patients, the surgery could be considered as an acceptable and effective method for treating such impairment and fracture.


2020 ◽  
Vol 9 (1) ◽  
pp. 17-21
Author(s):  
Ranjib Kumar Jha ◽  
Santosh Thapa

Background: An avulsion fracture of posterior cruciate ligament from tibial attachment is more common in younger age group. It should be fixed otherwise it may lead to secondary changes in knee. Various techniques and approaches are available to fix posterior cruciate ligament avulsion. Different biomechanical studies have shown that, results both open and arthroscopic methods of fixation of posterior cruciate ligament avulsion by screws are comparable. The purpose of study is to evaluate functional and clinical outcome of open reduction and fixation of posterior cruciate ligament avulsion injury through posteromedial approach. Materials and Methods: The study enrolled 19 cases of isolated posterior cruciate ligament avulsion injury with mean age of 33.21±9.07 year. All cases were treated by open reduction and internal fixation through modified posterior approach. The patients having duration of injury more than 12 weeks were excluded. The minimum follow up duration was 12 months. Results were assessed clinically and radiologically. Final functional outcome was assessed using the Lysholm scoring for knee. Results: The mean duration of follow up was 14±1.85 months. All patients achieved union at 3months. At final follow up the mean range of motion was 125.42±6.37 degree (range 110 to 135 degree) without any extensor lag. The functional outcome assessed by Lysholm scoring system was excellent in 15 cases and good in 4 cases. Conclusion: Open reduction and internal fixation with early range of motion exercises provides good clinical outcome and stable knee.


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