scholarly journals Arthroscopy-assisted surgery: The management of posterolateral tibial plateau depression fracture accompanying ligament injury: A case series and review of the literature

2019 ◽  
Vol 28 (1) ◽  
pp. 230949901989120
Author(s):  
Zhangfu Wang ◽  
Binbin Zheng ◽  
Yanjun Jin ◽  
Guangyong Yang ◽  
Guofu Chen ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Case Series ◽  
Soft Tissue Injuries ◽  
Acl Rupture ◽  
Ligament Injury ◽  
Surgical Trauma ◽  
Treatment Of Depression ◽  
Anterior Cruciate ◽  
Unusual Injury

Tibial plateau fractures are multiple fracture patterns associated with soft-tissue injuries. Among which, the combined existence of posterolateral tibial plateau depression fracture with anterior cruciate ligament (ACL) rupture has been reported rarely. Meanwhile, surgical method for the treatment of depression fracture is fairly complex. The aim of this article is to show a case series of this unusual injury pattern and the therapy of posterolateral tibial plateau depression fracture accompanying ACL rupture. In our treatment, arthroscopy assisted reduction of depression fracture and ACL reconstruction reduces surgical trauma and leads to good functional recovery. We also review the current literature.

scholarly journals Lateral femoral notch sign and posterolateral tibial plateau fractures and their associated injuries in the setting of an anterior cruciate ligament rupture

2021 ◽  
Author(s):  
Alexander Korthaus ◽  
Malte Warncke ◽  
Geert Pagenstert ◽  
Matthias Krause ◽  
Karl-Heinz Frosch ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Ligament Injury ◽  
Ligament Rupture ◽  
Impression Fracture ◽  
Anterior Cruciate ◽  
Lateral Femoral Notch ◽  
Femoral Notch

Abstract Introduction ACL injury is one of the most common injuries of the knee joint in sports. As accompanying osseous injuries of the ACL rupture a femoral impression the so-called lateral femoral notch sign and a posterolateral fracture of the tibial plateau are described. However, frequency, concomitant ligament injuries and when and how to treat these combined injuries are not clear. There is still a lack of understanding with which ligamentous concomitant injuries besides the anterior cruciate ligament injury these bony injuries are associated. Materials and methods One hundred fifteen MRI scans with proven anterior cruciate ligament rupture performed at our center were retrospectively evaluated for the presence of a meniscus, collateral ligament injury, a femoral impression, or a posterolateral impression fracture. Femoral impressions were described according to their local appearance and posterolateral tibial plateau fractures were described using the classification of Menzdorf et al. Results In 29 cases a significant impression in the lateral femoral condyle was detected. There was a significantly increased number of lateral meniscal (41.4% vs. 18.6% p = 0.023) and medial ligament (41.4% vs. 22.1%; p = 0.040) injuries in the group with a lateral femoral notch sign. 104 patients showed a posterolateral bone bruise or fracture of the tibial plateau. Seven of these required an intervention according to Menzdorf et al. In the group of anterior cruciate ligament injuries with posterolateral tibial plateau fracture significantly more lateral meniscus injuries were seen (p = 0.039). Conclusion In the preoperative planning of ACL rupture accompanied with a positive femoral notch sign, attention should be paid to possible medial collateral ligament and lateral meniscus injuries. As these are more likely to occur together. A posterolateral impression fracture of the tibial plateau is associated with an increased likelihood of the presence of a lateral meniscal injury. This must be considered in surgical therapy and planning and may be the indication for necessary early surgical treatment.

scholarly journals Importance of Posterior Tibial Slope, Medial Tibial Plateau Slope and Lateral Tibial Plateau Slope in Anterior Cruciate Ligament Injury

2021 ◽  
Vol 11 (09) ◽  
pp. 233-248
Author(s):  
Bernat Mas Matas ◽  
Irene Carrión Barberà ◽  
Salvatore Marsico ◽  
Anna Agustí Claramunt ◽  
Raúl Torres-Claramunt ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Tibial Slope ◽  
Ligament Injury ◽  
Medial Tibial Plateau ◽  
Lateral Tibial Plateau ◽  
Posterior Tibial ◽  
Tibial Plateau Slope ◽  
Anterior Cruciate

scholarly journals ANATOMICAL STUDY OF THE MORPHOMETRY OF THE ANTERIOR CRUCIATE LIGAMENT ATTACHMENT SITES. Estudio anatómico de la morfometría de los sitios de fijación del ligamento cruzado anterior

2016 ◽  
Vol 8 (1) ◽  
pp. 29-37
Author(s):  
Paul I Iyaji ◽  
Abduelmenem Alashkham ◽  
Abdulrahman Alraddadi ◽  
Roger Soames
Keyword(s):  
Anterior Cruciate Ligament ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Acl Rupture ◽  
Attachment Sites ◽  
Significant Difference ◽  
The Mean ◽  
Las Mujeres ◽  
Anterior Cruciate ◽  
Pl Bundle

Incidence of anterior cruciate ligament (ACL) rupture and its consequent reconstruction is on the rise. In contributing to the achievement of anatomic reconstruction this study seek to provide information regarding the position and variability of the tibial attachment sites, dimensions of femoral insertions and compare these measurements in males and females, and in right and left knees. Thirty one cadaveric knees (15 right and 16 left from 9 females and 7 males, mean age 77 years) were dissected. Various ACL footprint dimensions were taken. The mean length and width of the tibial anteromedial (AM) bundle footprint were 8.9 and 9.8 mm while that of the posterolateral (PL) bundle were 9.3 and 8.0 mm respectively. The mean length and width of the tibial AM and PL bundles in males were 8.5 and 9.8 mm, and 9.1 and 8.3 mm while corresponding values in females were and 9.2 and 9.7 mm, and 9.4 and 7.8 mm respectively.  Males had larger femoral footprints (P=0.020) and tibial plateau (P<0.001). No significant difference between the right and left knees were observed. The mean anatomical positions of the AM and PL bundles were 46.0% and 50.0% of the mediolateral diameter of the tibial plateau. The mean length and width of the ACL femoral insertion sites were 8.3 and 7.7 mm for the AM bundle and 7.8 and 6.9 mm for the PL bundle respectively. The smaller ACL attachment parameters in females could be a contributing factor to the higher incidence of ACL rupture in female athletes. La incidencia de la rotura del ligamento cruzado anterior (LCA) y su consiguiente reconstrucción está en aumento. Para contribuir a la actualización de la reconstrucción anatómica del ligamento cruzado anterior, este estudio proporciona información sobre la posición y la variabilidad de los sitios de fijación en la tibia, las dimensiones de las inserciones femorales, así como las relaciones de estas mediciones en hombres y mujeres y en las rodillas derecha e izquierda. Se disecaron treinta y un (15 rodillas de cadáver derecha, 16 izquierda, de 9 mujeres y 7 hombres, con una edad media de 77 años). Se tomaron diversas dimensiones de la huella del LCA. La longitud media y la anchura de la huella del haz tibial anteromedial (AM) eran 8,9 mm y 9,8 mm mientras que la del haz posterolateral (PL) eran 9,3 mm y 8 mm respectivamente. La longitud media y la anchura de la AM tibial y paquetes PL en los varones eran 8,5 y 9,8 mm, y 9,1 y 8,3 mm, mientras que los valores correspondientes en las mujeres eran 9,2 y 9,7 mm, y 9,4 y 7,8 mm, respectivamente. Los varones tenían huellas femorales (P = 0,045 para AM, P = 0,043 para PL) y la meseta tibial (P <0,001) más grandes. No se observó ninguna diferencia significativa entre la rodilla derecha e izquierda. Las posiciones anatómicas medias de los haces de AM y PL fueron 46% y 50% del diámetro mediolateral de la meseta tibial. La longitud media y la anchura de los sitios de inserción femoral del LCA fueron 8,3 y 7,7 mm para el paquete de AM y 7,8 y 6,9 mm para el paquete PL respectivamente. Los parámetros más pequeños de fijación del LCA en las mujeres podría ser un factor que contribuye a la mayor incidencia de rotura del LCA en mujeres atletas.   

scholarly journals Anterior Cruciate Ligament Injury and its Rehabilitation in Nepal

2021 ◽  
Vol 59 (239) ◽  
Author(s):  
Suraj Bhusal ◽  
Ujjwal Dotel ◽  
Shamed Kumar Katila ◽  
Saugat Shrestha
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Injury ◽  
Tibial Plateau ◽  
Treatment Approach ◽  
Femoral Condyle ◽  
Cruciate Ligament ◽  
Return To Play ◽  
Ligament Injury ◽  
Medial Aspect ◽  
Anterior Cruciate

Anterior cruciate ligament is one of the most common ligaments to get injured especially in athletic population. It is a band of dense connective tissue which arises from the antero-medial aspect of the inter condylar area on the tibial plateau and passes upwards and backwards to attach to the posteromedial aspect of the lateral femoral condyle. There is increasing rate of its reported injuries among athletes in Nepal and surgeons report increased consultations among athletes regarding adequate intervention strategies. Factors like over use, inadequate recovery time, playing surface, fitness incompatibility are involved in the increase of anterior cruciate ligament injury among athletes in Nepal. Treatment approach for anterior cruciate ligament injury is ever evolving with regular studies and innovation, but constant guidance and rehabilitation in an institution-based setting have shown positive feedback in recovery and return to play.

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