Sports Medicine Service, Beijing Jishuitan Hospital, Beijing, China.
Arthroscopy. 2011 May;27(5):728-34. doi: 10.1016/j.arthro.2010.11.004. Epub 2011 Mar 12.
Arcuate avulsion fractures are very rare but present pathologic posterolateral rotation instability. Untreated instability may lead to overload of the reconstructed posterior cruciate ligament (PCL) graft. Surgical treatment and clinical results have not yet been reported to our knowledge. This study presents the case of a 45-year-old man with PCL injury and an arcuate avulsion fracture of the fibular head. The dial test was positive preoperatively, and magnetic resonance imaging showed an "arcuate" sign. The avulsed bone fragment was reduced and fixed with a suture anchor by an all-arthroscopic technique. At the 1-year follow-up, the patient had resumed all his normal activities, including sports. He scored 1+ on the posterior drawer test, and external rotation was 1° less than that in his contralateral normal knee. Compared with the values in the contralateral normal knee, the posterior tibial translation was reduced from 15.5 mm preoperatively to 6.3 mm postoperatively. The postoperative magnetic resonance imaging and computed tomography scans showed that the reconstructed PCL graft and the osseous fragment of the styloid process of the fibular head attached to the popliteofibular ligament were reduced. This technical note describes an all-arthroscopic reduction and fixation technique of arcuate avulsed fracture of the fibular head.
弧形撕脱骨折非常罕见，但表现出病理性后外侧旋转不稳定。未治疗的不稳定可能导致重建后交叉韧带 (PCL) 移植物过载。据我们所知，尚未报道手术治疗和临床结果。本研究介绍了 1 例 45 岁男性的 PCL 损伤和腓骨头弧形撕脱骨折病例。术前抽屉试验阳性，磁共振成像显示“弧形”征。采用全关节镜技术，使用缝线锚钉将撕脱的骨块复位固定。在 1 年的随访中，患者恢复了所有正常活动，包括运动。他的后抽屉试验得分为 1+，外旋比健侧正常膝关节少 1 度。与健侧正常膝关节相比，胫骨后向平移从术前的 15.5mm 减少到术后的 6.3mm。术后磁共振成像和计算机断层扫描显示，重建的 PCL 移植物和附着于腓肠豆腓骨韧带的腓骨茎突骨块复位。本技术说明描述了一种全关节镜下复位固定腓骨头弧形撕脱骨折的技术。
