Artículos de revistas
Surgical Treatment Of Avulsion Fractures Of The Knee Pcl Tibial Insertion: Experience With 21 Cases [tratamento Cirúrgico Da Fratura-avulsão Da Inserção Tibial Do L.c.p. Do Joelho: Experiência De 21 Casos]
Registro en:
Acta Ortopedica Brasileira. , v. 15, n. 5, p. 272 - 275, 2007.
14137852
2-s2.0-39649115206
Autor
Piedade S.R.
Mischan M.M.
Institución
Resumen
We assessed 21 patients (16 males and 5 females), with mean age of 27.6 years who underwent surgical treatment for PCL avulsion fracture. In 57% of the cases, injuries were secondary to motorcycle accidents and 19% resulted from car accidents. Injuries on knee.s anterior surface were detected in 72% of the cases. The surgical procedure involved posterior approach and bone fragment fixation using nut and screw in 18 cases, the trans-bone suture loop fixation in 3 cases with small bone fragments. In 91% of the cases, surgery was performed within the first two weeks following injury. The patients were objectively (posterior drawer test) and subjectively (Lysholm scale) re-evaluated after a minimum follow-up period of 12 postoperative months. The statistical analysis of objective and subjective assessments did not demonstrate any significant difference (p = 0.05). The satisfactory results of the subjective clinical postoperative evaluation may have been due to the absence of peripheral ligament injury. However, the presence of residual tibial posteriorization suggests that the avulsion fracture of the PCL should be treated as bone-ligament injury, and not just as a bone lesion. 15 5 272 275 Wind WM Jr, Bergefeld JA, Parker RD. Evaluation and treatment of posterior cruciate injuries. Revisited. Am J Sports Med. 2004 32:1765-75Deeham, D.J., Pinczewski, L.A., Arthroscopic reattachment for an avulsion fracture of the tibial insertion of the posterior cruciate ligament. (2001) Arthroscopy, 17, pp. 422-425 Girgis, F.G., Marshall, J.L., Monarem, A.R.S., The cruciate ligaments of the knee joint: Anatomical, functional and experimental analysis (1975) Clin Orthop Relat Res, 106, pp. 216-231 Van Dommelen, B.A., Fowler, P.J., Anatomy of posterior cruciate ligament. A review (1989) Am J Sports Med, 17, pp. 24-29 de Abreu, M.R., Kim, H.J., Ching, C.B., Jesus, J.M., Cho, J., Trudell, D., Posterior cruciate ligament recess and normal posterior capsular insertional anatomy: MR imaging of cadaveric knees (2005) Radiology, 236, pp. 968-973 Meyers, M.H., Isolated avulsion of the tibial attachment of the posterior cruciate ligament of the knee (1975) J Bone Joint Surg Am, 57, pp. 669-672 Trickey, E.L., Injuries of the posterior cruciate ligament: Diagnosis and treatment of early injuries and reconstruction of late instability (1980) Clin Orthop Relat Res, 147, pp. 76-81 Torisu, T., Avulsion fractures to the tibial attachment of the posterior cruciate ligament: Indications and results of delayed repair (1979) Clin Orthop Relat Res, 143, pp. 107-114 Torisu, T., Isolated avulsion fractures to the tibial attachment of the the posterior cruciate ligament (1977) J Bone Joint Surg Am, 59, pp. 68-72 Seitz, H., Schlenz, I., Pajenda, G., Vecsei, V., Tibial avulsion fracture of the posterior cruciate ligament: K-wire or screw fixation? A retrospective study of 26 patients (1997) Arch Orthop Trauma Surg, 116, pp. 275-278 Vaselko, M., Saciri, V., Posterior approach for arthroscopic reduction and antegrade fixation of avulsion fracture of the posterior cruciate ligament from the tibia with cannulated screw and washer (2003) Arthroscopy, 19, pp. 916-921 Trickey, E.L., Rupture of the posterior cruciate ligament of the knee (1968) J Bone Joint Surg Br, 50, pp. 334-341 Burks, R.T., Schaffer, J.J., A simplified approach to the tibial attachment of the posterior cruciate ligament (1990) Clin Orthop Relat Res, 254, pp. 216-219 Lee, H.G., Avulsion fracture of the tibial attachments of the cruciate ligaments: Treatment by operative reduction (1937) J Bone Joint Surg, 19, pp. 460-468 Brenan, J.J., Avulsion injuries of the posterior cruciate ligament (1960) Clin Orthop Relet Res, 18, pp. 153-163 Kim, S.-J., Shin, S.-J., Cho, S.-K., Kim, H.-K., Arthroscopic suture fixation of bone avulsion of the posterior cruciate ligament (2001) Arthroscopy, 17, pp. 776-780 Shino, K., Nakata, K., Mae, T., Yamada, Y., Shiozaki, Y., Toritsuka, Y., Arthroscopic fixation of tibial bone avulsion of the posterior cruciate ligament (2003) Arthroscopy, 19, pp. 12e Inoue, M., Yasuda, K., Kondo, E., Saito, K., Ishibe, M., Primary repair of posterior cruciate ligament avulsion fracture. The effect of occult injury in the midsubstance on postoperative instability (2004) Am J Sports Med, 32, pp. 1230-1237