Department of Knee Surgery and Sports Medicine, Akhtar Orthopedic Training and Research Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Orthopedic Surgery, Poursina Hospital Orthopaedic Research Center, Guilan University of Medical Sciences, Rasht, Iran.
J Knee Surg. 2022 Jul;35(8):862-867. doi: 10.1055/s-0040-1721093. Epub 2020 Nov 25.
The optimal operative technique for the treatment of the tibial-side avulsion injuries of the posterior cruciate ligament (PCL) is debatable. This study was aimed to evaluate the postoperative outcomes and complications if any after an open direct, posterolateral approach using cannulated cancellous screw fixation of a PCL tibial avulsion. From January 2016 to June 2018, 17 patients (14 males and 3 females) with PCL avulsion fraction treatment-who underwent open reduction and internal fixation using cannulated cancellous screws-were included in this prospective study. A direct posterolateral approach in the prone position was used in all cases. The Lysholm's knee score and International Knee Documentation Committee (IKDC) score were assessed preoperatively and during regular follow-up examinations for at least 1 year (12-20 months) postoperatively. All patients had fracture union and all of their knees were stable upon physical examination. No nerve or blood vessel injuries occurred. The mean Lysholm's scores and mean IKDC scores were improved significantly at the last follow-up. This study provides evidence that open direct posterolateral approach may be reliable for the treatment of tibial-sided bony PCL avulsion fractures. This approach can provide direct visualization of the posterior capsule and PCL avulsion site associated with good reduction and stable fixation, easy application of the screws directly from posterior to anteriorly without extensive soft tissue damage. Nevertheless, long-term follow-up is recommended.
经皮空心螺钉固定治疗后交叉韧带胫骨止点撕脱骨折的手术技术选择仍存在争议。本研究旨在评估经皮空心螺钉直接后外侧入路切开复位治疗后交叉韧带胫骨止点撕脱骨折的术后疗效和并发症。2016 年 1 月至 2018 年 6 月，17 例（男 14 例，女 3 例）采用空心螺钉经皮固定治疗后交叉韧带胫骨止点撕脱骨折患者纳入本前瞻性研究。所有患者均采用俯卧位直接后外侧入路。术前及术后至少 1 年（12-20 个月）的定期随访评估采用 Lysholm 膝关节评分和国际膝关节文献委员会（IKDC）评分。所有患者均获得骨折愈合，体格检查均显示膝关节稳定，无神经或血管损伤。末次随访时，Lysholm 评分和 IKDC 评分均显著改善。本研究表明，经皮空心螺钉直接后外侧入路治疗胫骨侧后交叉韧带撕脱骨折是可靠的。该入路可直接观察后关节囊和后交叉韧带撕脱部位，便于复位和固定，可直接从后向前拧入螺钉，无需广泛的软组织损伤。但仍需长期随访。
