Department of Orthopedics, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, China.
Key Laboratory of Biomechanics of Hebei Province, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, China.
BMC Musculoskelet Disord. 2022 Sep 3;23(1):841. doi: 10.1186/s12891-022-05795-8.
The surgical technique for treatment of tibial avulsion fractures of the posterior cruciate ligament (PCL) remains challenging due to the deep-located lesion and the complexity of the anatomy. The purpose of this study was to report preliminary results of an arthroscopic technique in patients with the "hinged" type PCL tibial avulsion fractures.
Twenty-eight patients with the displaced "hinged" fractures with elevation of the posterior aspect of the bony fragment were arthroscopically treated. The bony fragment was reducted and fixed with the sutures passing through only one single tibial tunnel. The clinical outcomes were assessed by Lysholm score, Tegner activity score, and the side-to-side differences of KT-1000 measurement. The reduction and union of the fracture were assessed by radiography of the knee.
Patients were followed up for a mean of 19 (12 to 24) months. There were no surgery-related complications, and all patients regained normal range of motion of the knees at the last follow-up. The Lysholm score significantly increased from preoperative 14.78 ± 8.23 to postoperative 96.96 ± 3.62 (P = 0.000). The Tegner score was 6.78 ± 1.35 pre-injury and 6.48 ± 1.20 at the last follow-up with no statistical difference (P = 0.688). The KT-1000 side-to-side differences significantly decreased from 8.26(SD 1.86; 6 to 12) pre-operatively to 0.91 (SD 0.85; 0 to 3) (P = 0.000). X-rays showed that satisfactory reduction and solid union was achieved in all patients.
The arthroscopic suture fixation through single-tibial tunnel technique yielded good clinical and radiographic outcome for treatment of displaced "hinged" type of PCL avulsion fractures.
由于病变位置深，解剖结构复杂，后交叉韧带（PCL）胫骨撕脱骨折的手术治疗仍然具有挑战性。本研究旨在报告关节镜技术治疗“铰链”型 PCL 胫骨撕脱骨折患者的初步结果。
对 28 例伴有骨块后上方抬高的移位“铰链”型骨折患者进行关节镜治疗。骨块通过仅穿过一个胫骨隧道的缝线进行复位和固定。采用 Lysholm 评分、Tegner 活动评分和 KT-1000 测量的侧-侧差值评估临床结果。通过膝关节 X 线评估骨折的复位和愈合情况。
患者平均随访 19 个月（12-24 个月）。无手术相关并发症，所有患者在末次随访时均恢复了膝关节正常活动范围。Lysholm 评分由术前的 14.78±8.23 分显著提高至术后的 96.96±3.62 分（P=0.000）。术前 Tegner 评分为 6.78±1.35，末次随访时为 6.48±1.20，差异无统计学意义（P=0.688）。KT-1000 侧-侧差值由术前的 8.26（SD 1.86；6-12）显著减少至术后的 0.91（SD 0.85；0-3）（P=0.000）。X 线片显示所有患者均获得满意的复位和牢固愈合。
关节镜下经单一胫骨隧道缝线固定治疗移位“铰链”型 PCL 撕脱骨折可获得良好的临床和影像学结果。
