Clinical comparison of arthroscopy versus mini-open surgery for avulsion fracture of the tibial attachment of the posterior cruciate ligament
10.3760/cma.j.issn.1671-7600.2013.08.004
- VernacularTitle:关节镜与小切口手术治疗后交叉韧带胫骨附丽撕脱骨折的疗效比较
- Author:
Lei HONG
;
Hui ZHANG
;
Hua FENG
- Publication Type:Journal Article
- Keywords:
Posterior cruciate ligament;
Tibial fractures;
Arthroscopy;
Retrospective studies
- From:
Chinese Journal of Orthopaedic Trauma
2013;15(8):666-670
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the clinical outcomes of arthroscopy versus mini-incision surgery for the treatment of avulsion fracture of the tibial attachment of the posterior cruciate ligament (PCL).Methods From March 2001 to September 2009,84 patients with acute displaced avulsion fracture of the tibial PCL attachment were treated operatively in our department.Thirty-five patients were treated with arthroscopic reduction and suture fixation (Group 1); 49 patients were treated with open reduction through a mini-incision and internal fixation with cannulated screw(s) and washer(s) (Group 2).There were 27 males and 8 females in group 1,with a mean age of 29.6 ± 5.6 years old,and 40 males and 9 females in group 2,with a mean age of 32.2 ± 7.6 years old.Based on the Meyers & Mckeever classification,there were 24 type Ⅱ fractures and 11 type Ⅲ fractures in group 1,and 31 type Ⅱ fractures and 18 type Ⅲ fractures in group 2.The 2 groups were compared in terms of range of motion,posterior drawer test (PDT),Lysholm score,International Knee Documentation Committee (IKDC) grading,and clinical results.Results All the patients obtained an average follow-up of 21.5 months (range,13 to 34 months).Primary union was achieved in all the fractures 3 months postoperatively.There were no significant differences between group 1 and group 2 regarding the PDT negative rate [82.9％ (29/35) versus 91.8％ (45/49)],the Lysholm score (95.1 ± 5.6 versus 96.1 ±4.7),therate ofIKDC grade A [88.6％ (31/35) versus91.8％ (45/49)],or the rate of normal range of motion [94.3％ (33/35) versus 93.9％ (46/49)] (P ＞ 0.05).On average,group 1 used significantly longer operative time (92.4 ± 15.9 minutes) than group 2 (53.8 ± 14.3 minutes).Conclusions Both arthroscopy and mini-incision surgery can achieve satisfactory clinical outcomes in the treatment of PCL tibial avulsion fracture.Although the 2 methods make no significant differences in stability of the knee joint and clinical scores,mini-incision surgery can result in much shorter operative time and thus permit an early postoperative rehabilitation.
