Wang Xiong, Gu Qing, Zi Shuming, Wei Wenqiang, Cheng Biao, Cao Liehu
Department of Sports Medicine, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.
Department of Orthopedics, Shanghai Baoshan Luodian Hospital, Shanghai, China.
Front Bioeng Biotechnol. 2025 May 22;13:1496728. doi: 10.3389/fbioe.2025.1496728. eCollection 2025.
Posterior cruciate ligament (PCL) tibial avulsion fractures are relatively rare injuries that often result in chronic pain, limited range of motion, knee instability, and osteoarthritis. Most cases require surgical intervention to restore the fragment's normal anatomy, the ligament's tension, and the knee joint's stability. In this study, we propose a novel approach utilizing a modified suture bridge fixation technique to treat PCL tibial avulsion fractures and explore the clinical outcome and applicability.
We retrospectively reviewed and collected the clinical data from March 2020 to April 2023. Of the 24 patients (14 males and 10 females) with PCL tibial avulsion fractures who underwent modified suture bridge fixation technique were enrolled in the study. The surgical data of the surgery time and intraoperative blood loss were analyzed. The knee range of motion (ROM), the Lysholm knee scoring scale, and the International Knee Documentation Committee (IKDC) were used to evaluate the recovery of knee joint function.
All 24 patients were followed up for a duration ranging from 11 to 16 months, with an average of 13.00 ± 1.32 months. The surgery time was 40∼60 min, with a mean of 50.88 ± 4.85 min. The intraoperative blood loss was approximately 25∼45 mL, averaging 36.75 ± 4.89 mL. No instances of wound infection, neurovascular injuries, fracture nonunion, fixation failure, deep vein thrombosis, or secondary operation were reported during follow-up. The knee joint range of motion (ROM) was 118°∼134°, with an average of 127.46° ± 4.16° at the final follow-up. The Lysholm score was 41.17 ± 3.48 at the preoperative stage and improved to 90.25 ± 2.59 at the final follow-up. The IKDC score was 40.38 ± 2.16 at the preoperative stage, and 88.54 ± 1.77 at the final follow-up.
The results indicate that the novel approach utilizing a modified suture bridge fixation technique can provide effective stabilization and favorable clinical outcomes. The suture bridge structure can be applied to displaced posterior cruciate ligament (PCL) tibial avulsion fractures through its compression capabilities, especially in comminuted fractures. This procedure is straightforward, minimizing the risk of injury to peripheral neurovascular structures and eliminating the need for a second operation. Consequently, this technique represents a viable alternative treatment option for primary care facilities or hospitals that lack arthroscopic equipment.
后交叉韧带（PCL）胫骨撕脱骨折是相对罕见的损伤，常导致慢性疼痛、活动范围受限、膝关节不稳定和骨关节炎。大多数病例需要手术干预以恢复骨折块的正常解剖结构、韧带张力和膝关节稳定性。在本研究中，我们提出一种利用改良缝线桥固定技术治疗PCL胫骨撕脱骨折的新方法，并探讨其临床疗效和适用性。
我们回顾性分析并收集了2020年3月至2023年4月的临床资料。纳入24例行改良缝线桥固定技术治疗的PCL胫骨撕脱骨折患者（男14例，女10例）。分析手术时间和术中失血量等手术数据。采用膝关节活动度（ROM）、Lysholm膝关节评分量表和国际膝关节文献委员会（IKDC）评分评估膝关节功能恢复情况。
24例患者均获随访，随访时间11～16个月，平均（13.00±1.32）个月。手术时间40～60分钟，平均（50.88±4.85）分钟。术中失血量约25～45毫升，平均（36.75±4.89）毫升。随访期间未报告伤口感染、神经血管损伤、骨折不愈合、固定失败、深静脉血栓形成或二次手术等情况。末次随访时膝关节活动度（ROM）为118°～134°，平均（127.46°±4.16°）。术前Lysholm评分为（41.17±3.48）分，末次随访时提高至（90.25±2.59）分。术前IKDC评分为（40.38±2.16）分，末次随访时为（88.54±1.77）分。
结果表明，利用改良缝线桥固定技术的新方法能提供有效的固定并取得良好的临床疗效。缝线桥结构通过其加压能力可应用于移位的后交叉韧带（PCL）胫骨撕脱骨折，尤其是粉碎性骨折。该手术操作简单，可将外周神经血管结构损伤风险降至最低，且无需二次手术。因此，对于缺乏关节镜设备的基层医疗机构或医院而言，该技术是一种可行的替代治疗选择。
