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用于腓骨撕脱骨折情况下后外侧角重建的可调环皮质悬吊装置:病例系列及新技术描述

Adjustable-loop cortical suspension device for posterolateral corner reconstruction in the setting of fibular avulsion fracture: a case series and novel technique description.

作者信息

Wohler Andrew D, Trofa David P, Meade Joshua D, Hong Ian S, Moorman Claude T, Piasecki Dana P, Saltzman Bryan M, Fleischli James E

机构信息

Department of Orthopaedic Surgery, Atrium Health, Charlotte, NC, USA.

Columbia University Medical Center, New York, NY, 10032, USA.

出版信息

Arch Orthop Trauma Surg. 2023 Apr;143(4):1981-1987. doi: 10.1007/s00402-022-04412-6. Epub 2022 Mar 19.

Abstract

INTRODUCTION

A novel technique using an adjustable-loop cortical suspension toggle device for reduction of a fibular head avulsion fracture (arcuate fracture) in posterolateral corner (PLC) reconstruction is described. Results of clinical follow-up are presented.

MATERIALS AND METHODS

9 patients were retrospectively identified who underwent posterolateral corner reconstruction using an adjustable-loop cortical suspension toggle device. Radiographic examination was used to evaluate the successful healing of the avulsed fibular head fragments post-operatively.

RESULTS

7 patients reported satisfactory results with their clinical outcome with no feelings of knee instability or objective instability on exam at final follow-up. Post-operative radiographs obtained > 6 months following reconstruction demonstrated well reduced and healed fracture in 5 of 6 patients, with 1 patient demonstrating maintained reduction but incomplete fracture union at 6 months.

CONCLUSION

This novel surgical technique for PLC reconstruction with an avulsed fibular head fracture is a viable alternative to previously described methods. The majority of patients report subjective satisfaction with a stable knee post-operatively.

LEVEL OF EVIDENCE

IV.

摘要

介绍

本文描述了一种使用可调节环皮质悬吊肘节装置减少后外侧角(PLC)重建中腓骨头撕脱骨折(弓形骨折)的新技术。并展示了临床随访结果。

材料与方法

回顾性纳入9例使用可调节环皮质悬吊肘节装置进行后外侧角重建的患者。通过影像学检查评估术后撕脱的腓骨头碎片的愈合情况。

结果

7例患者报告临床结果满意,末次随访时检查无膝关节不稳定感或客观不稳定情况。重建后>6个月获得的术后X线片显示,6例患者中有5例骨折复位良好且愈合,1例患者在6个月时骨折复位良好但未完全愈合。

结论

这种用于伴有腓骨头撕脱骨折的PLC重建的新手术技术是先前所述方法的可行替代方案。大多数患者术后对膝关节稳定主观满意。

证据等级

IV级。

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