Displaced Posterior Cruciate Avulsion Fracture Fixation With Medial Collateral Ligament and Lateral Meniscus Injury Using Combined Open and Arthroscopic Methods
Ontology highlight
ABSTRACT:
SUBMITTER: Kanakamedala A
PROVIDER: S-EPMC10995734 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:Avulsion fracture of the tibial insertion of the posterior cruciate ligament (PCL) receives constant concern. Arthroscopic procedures have long been attempted because of their minimally invasive nature, and various related techniques have been reported. However, the best arthroscopic method is still being pursued. In this article, we introduce an arthroscopic suture ligation and backup adjustable-loop fixation technique for PCL tibial avulsion fracture. The critical points of this technique are proper ligation of the PCL, proper location of the 2 tibial tunnels to create pulleys for posterior-inferior reduction of the bone fragment, and additional backup suture loop fixation. Our experience indicates that this technique is efficient and relatively simple. We consider that the introduction of this technique will provide a reasonable choice in the treatment of PCL tibial avulsion fracture.
| S-EPMC8252814 | biostudies-literature
Project description:Posterior cruciate ligament avulsion fracture injuries have been associated with an increased risk of meniscal tears and premature patellofemoral/medial compartment osteoarthritis. Sports-related trauma is a common cause of posterior cruciate ligament avulsion fractures. Surgical management is recommended for displaced bony avulsion of the posterior cruciate ligament to stabilize the knee and prevent knee pain, nonunion, and osteoarthritis progression. This article discusses our preferred treatment using a loop suspensory fixation device through a dual posteromedial portal technique.
| S-EPMC11873527 | biostudies-literature
Project description:This study describes an arthroscopic pullout fixation technique for small and comminuted avulsion fractures of the posterior cruciate ligament from the tibia. Intra-articular surgery required 3 arthroscopic portals, the anterolateral, anteromedial, and posteromedial portals. To simplify surgery, the posterolateral portal was omitted. A 2.4-mm K-wire was inserted through the anterior incision to the center of the bone fragment. This central guidewire was subsequently overdrilled with a 4.0-mm cannulated drill. The fixation material consisted of Pass Telos artificial ligaments inserted through the fiber loop of a fixed suspensory device such as RIGIDLOOP. The leading end of the thread of the RIGIDLOOP was pulled out through the anteromedial portal. The button of RIGIDLOOP was gradually advanced through the bone tunnel. The button was pulled out and flipped over the bony fragment. The artificial ligament was pulled distally to reduce the bony fragment, and fixed onto the tibia using a ligament button while applying anterior drawer force to the proximal tibia with the knee flexed at 90°. This minimally invasive procedure was successful in treating small and comminuted avulsion fracture of the tibial attachment of the posterior cruciate ligament.
| S-EPMC7695752 | biostudies-literature
Project description:Few cases of anterior cruciate ligament (ACL) tibial avulsion injuries occur in adolescents. Bony ACL avulsion from the tibial side has been treated by various methods ranging from conservative management to a wide range of operative procedures. Various arthroscopic operative procedures are available to reduce and fix these fractures. We describe a technique of arthroscopic "8" knotted fixation without any tibial tunnels for tibial-sided ACL avulsion. This simple technique avoids the potential complications of hardware fixation within a joint. It represents an arthroscopic treatment option for ACL tibial avulsion injuries.
| S-EPMC11873494 | biostudies-literature
Project description: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. Compared with other methods of fixation, our technique uses no tunnels; requires only 3 portals; yields no iatrogenic cartilage or meniscal injury; uses a single implant (anterior-row anchor); and is bone sparing, economical, and simple.
| S-EPMC11662862 | biostudies-literature
Project description:Arthroscopic partial medial meniscectomy is a very common orthopaedic procedure performed for symptomatic, irreparable meniscus tears. It is usually associated with a very good outcome and minimal complications. In some patients with tight medial compartment, the posterior horn of the medial meniscus can be difficult to visualize, and access in this area with instruments may be challenging. To increase the opening of the medial compartment, after valgus-extension stress position of the knee, different techniques of deep medial collateral ligament release have been described. The outside-in pie-crusting technique shown in this technical note has documented effectiveness and good outcomes with minimal or no morbidity.
| S-EPMC5040130 | biostudies-literature
Project description:Avulsion fracture of the posterior cruciate ligament from its tibial insertion is a rare condition. Early surgical treatment has been regarded as necessary, but the optimal surgical technique remains unclear. 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 using the TightRope device (Arthrex, Naples, FL).
| S-EPMC4130139 | biostudies-literature
Project description: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. 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. An arthroscopic procedure has the advantage of being minimally invasive and allowing the surgeon to detect and treat associated intra-articular injuries. We present an arthroscopic reduction-internal fixation technique using an adjustable-length loop device. A trans-septal portal is created to visualize the fracture fragment directly, and the fragment is reduced and penetrated with a cannulated drill under fluoroscopic guidance. 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. By tightening the loop, downward compression can be applied to the fragment. Overall, this technique provides good reduction and bone union, and excellent clinical outcomes, including posterior knee stability, can be achieved.
| S-EPMC7768234 | biostudies-literature
Project description:A femoral-sided avulsion fracture of the anterior cruciate ligament (ACL) is a rare and challenging condition. Most reported cases have occurred in childhood or adolescence. Many techniques of ACL repair have been reported, and in recent years, techniques in arthroscopic surgery have been developed and have become ever more popular with orthopaedic surgeons. We created a technique of arthroscopic ACL repair with suture anchor fixation for a femoral-sided ACL avulsion fracture. This technique saves the natural ACL stump. It is available for cases in which creation of a tibial tunnel is not allowed. Moreover, it does not require a skin incision for fixation on the far femoral cortex and, therefore, does not require a second operation to remove the fixation device. The arthroscopic technique also has a good cosmetic outcome.
| S-EPMC4523717 | biostudies-literature
Project description:Tibial eminence avulsion fractures are rare injuries occurring mainly in adolescents and young adults. When necessary, regardless of patient age, anatomic reduction and stable internal fixation are mandatory for fracture healing and accurate restoration of normal knee biomechanics. Various arthroscopically assisted fixation methods with sutures, anchors, wires, or screws have been described but can be technically demanding, thus elongating operative times. The purpose of this article is to present a technical variation of arthroscopic suture fixation of anterior cruciate ligament avulsion fractures. Using thoracic drain needles over 2.4-mm anterior cruciate ligament tibial guidewires, we recommend the safe and easy creation of four 2.9-mm tibial tunnels at different angles and at specific points. This technique uses thoracic drain needles as suture passage cannulas and offers 4-point fixation stability, avoiding potential complications of bony bridge fracture and tunnel connection.
| S-EPMC4314561 | biostudies-literature