ZHU Botao 1,2 , DONG Peilong 2 , TANG Xiaobo 2 , LI Zhiyun 2 , WANG Youhua 1
  • 1. Department of Orthopedics, Affiliated Hospital of Nantong University, Nantong Jiangsu, 226001, P. R. China;
  • 2. Department of Orthopedics, Jianhu Clinical Medical College of Yangzhou University, Yancheng Jiangsu, 224700, P. R. China;
WANG Youhua, Email: wangyouhuatu@126.com
Arthroscopy; single bone tunnel; wire; posterior cruciate ligament; tibial insertion fracture; adult
10.7507/1002-1892.202303026
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Objective  To explore the effectiveness of arthroscopic binding fixation using suture through single bone tunnel for posterior cruciate ligament (PCL) tibial insertion fractures in adults. Methods  Between October 2019 and October 2021, 16 patients with PCL tibial insertion fractures were treated with arthroscopic binding fixation using suture through single bone tunnel. There were 11 males and 5 females with an average age of 41.1 years (range, 26-58 years). The fractures were caused by traffic accident in 12 cases and sports in 4 cases. The time from injury to operation ranged from 2 to 10 days with an average of 6.0 days. The fractures were classified as Meyers-McKeever type Ⅱ in 4 cases and type Ⅲ in 9 cases, and Zaricznyi type Ⅳ in 3 cases. There were 2 cases of grade Ⅰ, 7 cases of grade Ⅱ, and 7 cases of grade Ⅲ in the posterior drawer test. There were 3 cases combined with lateral collateral ligament injury and 2 cases with meniscus injury. The visual analogue scale (VAS) score, Lysholm score, International Knee Documentation Committee (IKDC) score, and knee range of motion were used to evaluate knee joint function. The posterior drawer test and knee stability tester (Kneelax 3) were used to evaluate knee joint stability. The X-ray films were used to evaluate fracture reduction and healing. Results  All incisions healed by first intention after operation. There was no incision infection, popliteal neurovascular injury, or deep venous thrombosis of lower limbs. All patients were followed up 6-12 months, with an average of 10 months. X-ray films at 6 months after operation showed the fractures obtained bone union. There were 11 cases of grade 0, 4 cases of gradeⅠ, and 1 case of grade Ⅱin posterior drawer test, showing significant difference when compared with preoperative results (Z=23.167, P<0.001). The VAS score, Lysholm score, IKDC score, knee range of motion, and the results of Kneelax3 examination all significantly improved when compared with preoperative results (P<0.05). Conclusion  For adult patients with PCL tibial insertion fractures, the arthroscopic binding fixation using suture through single bone tunnel has the advantages of minimal trauma, good fracture reduction, reliable fixation, and fewer complications. The patient’s knee joint function recovers well.

Citation： ZHU Botao, DONG Peilong, TANG Xiaobo, LI Zhiyun, WANG Youhua. Effectiveness of arthroscopic binding fixation using suture through single bone tunnel for posterior cruciate ligament tibial insertion fracture in adults. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(6): 658-662. doi: 10.7507/1002-1892.202303026 Copy

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