pcl avulsion fracture arthroscopic fixation

0000034494 00000 n %PDF-1.4 %�� 0000005177 00000 n 0000172984 00000 n Rupture of the posterior cruciate ligament of the knee. 0000239054 00000 n These techniques include the use of various fixation devices such as screws, K-wires, wiring, sutures, and suture anchors. 0000172405 00000 n INTRODUCTION: To describe the clinical outcomes of arthroscopic fixation of displaced posterior cruciate ligament (PCL) avulsion fractures with/without associated tibia plateau fractures using an adjustable loop suspensory fixation device. An arthroscopic procedure has the advantage of being minimally invasive and allowing the surgeon to detect and treat associated intra-articular injuries. xref 0000279190 00000 n 2003; 19:916-21. 0000239320 00000 n 0000002570 00000 n Full ICMJE author disclosure forms are available for this article online, as supplementary material. 0000000016 00000 n 0000219909 00000 n endstream endobj 389 0 obj <>stream ... (3 cm or more in width) of an avulsion fracture of the posterior cruciate ligament with multiple cannulated screws have been described, those for a smaller fragment (1.5 cm or less in width) have not been well documented. 0000002220 00000 n 0000255176 00000 n 0000219648 00000 n Records were reviewed of 18 patients (median age 33.5 years, range 13–55 years) with PCL tibial avulsion fractures treated with an arthroscopic … trailer <<19FCA432CD824B41A6FBFA9B5ADE339A>]/Prev 662434/XRefStm 2220>> 0000034922 00000 n A large bony fragment that extended into the posterior part of the lateral tibial plateau allowed for reduction and retrograde fixation … endstream endobj 379 0 obj <>/Metadata 34 0 R/PageLabels 31 0 R/Pages 33 0 R/StructTreeRoot 36 0 R/Type/Catalog/ViewerPreferences<>>> endobj 380 0 obj <>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/TrimBox[0.0 0.0 595.276 841.89]/Type/Page>> endobj 381 0 obj <> endobj 382 0 obj <> endobj 383 0 obj <> endobj 384 0 obj <> endobj 385 0 obj <> endobj 386 0 obj <>stream 378 73 We report a case of avulsion fracture of the tibial attachment of the PCL managed by arthroscopic reduction and fixation. Arthroscopy . Arthroscopic surgery has the added advantage of being minimally invasive with fewer wound healing problems as compared with open surgery. 0000198382 00000 n endstream endobj 449 0 obj <>/Filter/FlateDecode/Index[36 342]/Length 34/Size 378/Type/XRef/W[1 1 1]>>stream 0000042587 00000 n 0000004417 00000 n A displaced avulsion fracture at the tibial attachment of the posterior cruciate ligament is considered an indication for surgical reduction and internal fixation … Methods. Early surgical treatment has been regarded as necessary, but the optimal surgical technique remains unclear. The mean age was 30.8 years. 0000262731 00000 n 0000220379 00000 n arthroscopically assisted reduction and wire loop fixation of avulsion fractures of the PCL from the tibia. 0000147507 00000 n PCL avulsion fractures, although rare, should undergo fixation when displacement is present. Repairing a PCL avulsion can be either through the conventional open approach or through arthroscopic surgery. H�\��j�0��~ A displaced avulsion fracture at the tibial attachment of the posterior cruciate ligament is considered an indication for surgical reduction and internal fixation because nonunion and remaining posterior instability of the knee are common consequences of conservative treatment. 0000279458 00000 n In 6 patients a suture-bridge technique via a mini-open approach was performed due to … 0000043182 00000 n Posterior cruciate ligament (PCL) avulsion-fracture arthroscopic reinsertion utilizing a posterior trans-septal arthroscopic approach. Finally, an interference screw was squeezed into the tunnel to fix the end of the loop. 0000197897 00000 n 11. ��t��qE��N�p�L֎7��*��N%8� J�U��#��ą� arthroscopic fixation with screws or sutures5-7. Obtain definitive fixation with the method dictated by the fracture orientation. Treatment of tibial PCL avulsion fractures by arthroscopic suture fixation is a successful technique to restore tibial avulsion injuries of the PCL … 0000148016 00000 n 0000262134 00000 n Material and method: June 2009 to March 2015, 15 patients with PCL tibia insertion avulsion fracture underwent arthroscopic reduction and modified figure eight wire loop fixation. [ Links ] 12. 0000172036 00000 n 0000255439 00000 n Arthroscopic fixation of posterior cruciate ligament avulsion fractures: A new minimally invasive technique. 378 0 obj <> endobj 0000124755 00000 n The VDO demonstrate technique of the Arthroscopic fixation ACL avulsion fracture. Abstract & Commentary. We report a case of avulsion fracture of the tibial attachment of the PCL managed by arthroscopic reduction and fixation. 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. 0000011464 00000 n 0000148797 00000 n August 11, 2015. Keywords: delayed avulsion fracture; posterior cruciate ligament; suture fixation… A total of 22 patients with a tibial avulsion fracture involving the insertion of the posterior cruciate ligament (PCL) with grade II or III posterior laxity were reduced and fixed arthroscopically using routine anterior and double posteromedial portals. Prepare the osseous bed and remove hematoma and/or debris. In this study, we evaluate a new wiring technique for the treatment of these injuries. 0000197870 00000 n Arthroscopic Bridge Technique for PCL Avulsion: Surgical Technique and Key Points Abstract This study describes all-arthroscopic fixation of the posterior cruciate ligament avulsion fracture using ‘suture bridge technique’. �r�ϲ"[*�9��Ґ|RI�H�V�A:�Y4�i��4TA�HH+� �E�t�+"��-� *Z�Vq arthroscopically assisted reduction and wire loop fixation of avulsion fractures of the PCL from the tibia. We used this technique in 3 consecutive patients. �c^��A�t�kѶh��H��Y$�Z$U��hM8%�ޢh-�c3R��)LL�D21E�sf��u�T3�db$SQ�(��y�Hi4Ȕh�H1�H��LE1�H�I�LE�ݜ9��O)��B�� eQ�, j��vYB�)D}RCT$ D �B�m��F��:ۤ^�m��%~�\��]��w�g�ϕ�C�J=�t�gҹ;�N�E�P��>=A}��.�8��U�Ŝ��&�囒�G�[�� $�,�uM}-��D�쳆3nx]�.h�� })� �(j(��[�ra3� ��D|� ��i�wx߄��\��(��w�W� K%� It does not 0000003253 00000 n 0000278618 00000 n 0000003842 00000 n 0000197502 00000 n Several techniques of arthroscopic treatment of tibial spine avulsion fractures have been described in the literature. Arthroscopic fixation using a suspensory fixation device was found to require only anteromedial, anterolateral, and posteromedial portals, without the need for a posterolateral portal. Dhillon MS, Singh HP, Nagi ON. [7] T. Torisu, Isolated avulsion fracture of the tibial attachment of the posterior cruciate ligament, J … The bone hole was made with a 2-mm K wire, allowing its use for small and shattered bone fragments. 450 0 obj <>stream The authors report no conflicts of interest in the authorship and publication of this article. A double-strand Ethibond suture was inserted into the joint and wrapped around the PCL from anterior to … %%EOF 0000043845 00000 n Confirm reduction under fluoroscopy with emphasis on sagittal plane alignment. 318 Nakagawa et al. Synopsis: A retrospective, nonrandomized study of arthroscopically assisted PCL-avulsion reattachments in 13 patients (14 knees) are described.Simultaneous posterolateral and posteromedial portals were used to insert ligament sutures (23 gauge wire or multiple sutures) or screw fixation. The primary means for surgically treating a PCL avulsion fracture are open reduction through the direct posterior or posteromedial approach 3 and arthroscopic reduction and internal fixation. PCL Avulsions: Arthroscopic Fixation. 1997; 13(6):759-762. 0000262394 00000 n 0000003121 00000 n By Volker Musahl 10 Videos FEATURING Jonathan Watson. We use cookies to help provide and enhance our service and tailor content and ads. 1 The open technique is relatively invasive despite its limited operative field, whereas the arthroscopic procedure has the advantage of allowing the surgeon to detect and treat associated intra-articular lesions. 0000042991 00000 n Arthroscopic reduction and fixation of bony avulsion of the posterior cruciate ligament of the tibia. We hypothesize that the patients will report ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. Arthroscopic Reduction and Internal Fixation of Posterior Cruciate Ligament Avulsion Fracture Using an Adjustable-Length Loop Device. 0000003956 00000 n A total of 30 acute (<3 weeks) isolated PCL tibial avulsion fractures were fixed under arthroscopy using the Endobutton device. 0000148396 00000 n This technique pro-vides accurate reconstruction of the anatomic footprint and rigid ﬁxation for early rehabilitation, and it can address concomitant intra-articular lesions. The problems with standard open surgical techniques are that they are relatively invasive despite the limited operative field and it is impossible to explore intra-articular lesions by the posterior approach. Reduce the avulsed fragment and obtain provisional fixation with Kirschner wires. [All-arthroscopic Fixation of Tibial Posterior Cruciate Ligament Avulsion Fractures With a Suture-Button Technique] Since 2016 eight tibial PCL avulsions were treated. Abstract. Overall, this technique provides good reduction and bone union, and excellent clinical outcomes, including posterior knee stability, can be achieved. 0000001791 00000 n 0000091230 00000 n This video showcases the open reduction and internal fixation of both an avulsed PCL (tibial ... read more ↘. By continuing you agree to the use of cookies. An adjustable-length loop device is relayed from the posteromedial portal and pulled out through the fragment in an anterograde fashion, placing a button on top of the fragment. These techniques include the use of various fixation devices such as screws, K-wires, wiring, sutures, and suture anchors. 0000050102 00000 n present a novel surgical approach for isolated PCL avulsion fractures consisting of an arthroscopic tech-nique using the TightRope device. In this study, we evaluate a new wiring technique for the treatment of these injuries. After arthroscopic exploration and reduction of the bony fragment, a single tibia tunnel was established; then, the titanium button was guided through the tunnel and flipped onto the bony fragment to stabilize the fracture. Most authors suggest that displaced PCL avulsion fractures should undergo operative fixation and current data suggests excellent outcomes when treating these patients with either open or arthroscopic fixation, with a low complication rate. 0000004444 00000 n ��+P�s�f�u�ؠM��I�� wJ��z��|xӽ��d�׭G��Z�Ia��I�o�%&N��>��6�P��FH/��>��]GS��l@��]�U��a��I��u��Q�� -�Y��V��$�R��Ļw�7R,j�g�e��B�>�z�b ��*ʨK��ڤ^J��q�X{�+#�k��в2C��01|(=��X��ta@ The purpose of this technical note is to present a novel all-inside arthroscopic reconstruction technique for bony tibial avulsion fractures of the posterior cruciate ligament … 0000042292 00000 n h�b``� �X6�� cg`a��(��X��~��#��Lǳs�6�L"��Z�d��ynn��w��R � KKK� [�t� ��8?�Ү@��f`�a�d�Ĩ��tH�D�Db��D�zF�(�LF�J�%Ok%��53h3��0|d For instance, Huang et al. h�bb�f`b``Ń3� ��C;> d�� Arthroscopy. The purpose of this study was to objectively evaluate the functional results after open reduction and internal fixation of tibial PCL avulsion fractures with international knee documentation committee (IKDC) grades and stress radiography. All were satisfied and returned to the activities prior to injury. Copyright © 2021 Elsevier B.V. or its licensors or contributors. 4, 9, 10 An arthroscopic fixation technique for avulsion fractures of the PCL with a small or comminuted fragment was found to require drilling a 2-mm hole in the tibia, 4 a surgical … 0000149046 00000 n 0000050798 00000 n In summary, the presented technique offers the opportunity to achieve arthroscopic, anatomic reconstruction of tibial bony avulsion fractures of the PCL. 0000016983 00000 n 0000035643 00000 n An avulsion fracture of the PCL, if not surgically fixed, may lead to secondary changes in the knee joint. An arthroscopic fixation technique for avulsion fractures of the PCL with a small or comminuted fragment was found to require drilling a 2-mm hole in the tibia, 4 a surgical procedure that was convenient and less invasive than previous methods.

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