scholarly journals Functional outcome of posterior cruciate ligament avulsion injuries treated with open reduction and cannulated cancellous screw fixation

2020 ◽  
Vol 6 (3) ◽  
pp. 363-366
Author(s):  
Prathap US ◽  
Keshava Murthy D ◽  
Narkhede Yogesh Dilip
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.


Author(s):  
Aniruddha Mondal ◽  
Ayon Das

<p class="abstract"><strong>Background:</strong> PCL (posterior cruciate ligament) is the main posterior stabilizer of the knee and plays a role in central axis controlling and imparting rotational stability to the knee. Injury to PCL presents commonly with avulsion fractures from its tibial attachment. An avulsion fracture of the PCL, if not surgically fixed, may lead to secondary changes in the knee joint. The aim of the study was to evaluate the clinical and functional results in patients with PCL tibial avulsion fractures treated by CC (cannulated cancellous) screw fixation.</p><p class="abstract"><strong>Methods:</strong> This was a prospective study conducted at a tertiary care government hospital in Kolkata, between December 2018 to July 2020 on patients who underwent CC screw fixation for post-traumatic PCL avulsion fracture from tibial site. All patients were followed up for 9 months. Lysholm knee score was used to assess the functional outcomes of the patients.<strong></strong></p><p class="abstract"><strong>Results:</strong> In a total of 10 patients, 9 (90%) patients showed excellent and 1 (10%) patient had good result during the final follow-up. 80% patients did not develop any complications. At the end of 9 months, the mean Lysholm score was 95.6. 8 (80%) patients achieved almost full knee ROM post-operatively by the end of final follow-up.</p><p class="abstract"><strong>Conclusions:</strong> Surgical fixation using CC screws is a simple, easy, safe and reproducible method without requiring significant expertise for achieving good stability in PCL tibial site avulsion fractures, where early intervention prevents significant late disability as it provides an excellent clinical, functional and radiographic outcome along with good joint function.</p><p> </p>


2017 ◽  
Vol 29 (3) ◽  
pp. 210-216 ◽  
Author(s):  
Sachin Joshi ◽  
Chirag Bhatia ◽  
Ashwin Gondane ◽  
Avinash Rai ◽  
Sumer Singh ◽  
...  

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.


1993 ◽  
Vol 18 (2) ◽  
pp. 219-224 ◽  
Author(s):  
R. NAKAMURA ◽  
E. HORII ◽  
K. WATANABE ◽  
K. TSUNODA ◽  
T. MIURA

50 patients with scaphoid non-union were treated by open reduction, anterior wedge bone grafting and internal fixation using the Herbert screw. Intra-operative image intensiner control enabled us to insert the screw into the scaphoid accurately. An excellent or good functional outcome was less likely when more than 5 years had elapsed since injury, the non-union was in the proximal third, when sclerosis of the proximal fragment was present, and when reduction of carpal and scaphoid deformity was unsatisfactory. These four factors are believed to be the primary determinants affecting the functional results of the surgical treatment of scaphoid non-union, even when bony union is achieved.


2012 ◽  
Vol 9 (4) ◽  
pp. 267-273 ◽  
Author(s):  
N P Parajuli ◽  
D Shrestha ◽  
D Dhoju ◽  
R Shrestha ◽  
V Sharma

Background Most scaphoid fractures though heal uneventfully with cast treatment, immobilization with cast is associated with complication like wrist stiffness. Open reduction and fixation with Herbert Screw though technically demanding procedure can yield excellent results and prevents complication like nonunions and loss of wrist function. Objectives To assess clinical outcome and radiological union of scaphoid fracture after operative management following Herbert screw fixation in patient attending Dhulikhel Hospital. Methods All scaphoid fracture, treated from Feb 2007 till Feb 2011, were retrospectively studied in Dhulikhel Hospital, Kathmandu University Hospital. Fifteen patients with scaphoid fractures were treated with Herbert screw. Fourteen were males and one was female. Serial radiographs were taken to assess radiographic union and functional outcome was assessed using Modified Mayo wrist score. Results Out of 15 patients, 13 scaphoid had waist fractures and two had proximal pole factures. All scaphoid were treated with open reduction and Herbert screw fixation either by volar approach or by dorsal approach. All fractures maintained good alignment post operatively. Nine (60%) patients had excellent results with normal wrist range of motion, five (33.3%) patients had good results and one (6.7%) patient had poor outcome. In 14 (93.3%) patients good radiological union was seen at final follow up at six months time. Conclusion Fixation with Herbert screw for scaphoid fracture is an effective and convenient way of treatment with satisfactory functional outcome and less complication.DOI: http://dx.doi.org/10.3126/kumj.v9i4.6342 Kathmandu Univ Med J 2011;9(4):267-73


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