Treatment Of Posterior Cruciate Ligament Tibial Avulsion Fracture With Internal Fixation After Internal Fixation With Internal Fixation Of Small Internal Incision Of Posterior Knee

Purpose: To explore the the clinical efficacy of arthroscopically assistedtreatment of tibial avulsion fracture of the posterior cruciate ligament(PCL)using spiked spacer and cannulated screw via small incision behind knee.Methods: Between May2012and January2014，22patients with tibial avulsionfracture of the PCL underwent arthroscopically assisted using spiked spacer andcannulated screw via small incision behind knee.Regularly followed up afteroperation,and to review the knee X-ray,to learn the fracture healing,the jointstability, range of motion (ROM)and postoperative complications and woundhealing,using the Lysholm score of knee joint to evaluate the recovery of theknee joint function.Results: All patients were followed up after operation,followed-up timeranged from3to20months(average,10.5months).Review the knee joint X-rayregularly,the average healing time of the fracture was6weeks.In addition to2patients were1degree positive for anti-Lachman test,the results of posteriordrawer test and anti-Lachman test were negative in other patients.The averageof the knee joint ROM was (45.75±10.35)°when treatment,which is (135.65±4.48)°on average after6months,showing significant difference betweenthem.2patients reported mild joint pain, and had uncomfortable feelings whenup and down stairs,the other patients had no obvious symptoms.The Lysholm scorewas improved to95.68±3.25at6months after operation,showing significantdifference when compared with the preoperative score(P＜0.05).Conclusion: The method of arthroscopically assisted treatment of tibialavulsion fracture of the PCL using spiked spacer and cannulated screw via smallincision behind knee is simple and easy，not only can treat associatedintra-articular injuries under the arthroscopic, and can fix the avulsionfracture under direct vision.The combination of minimally invasive arthroscopic and open surgery gives full play to their respective advantages, reduces thetechnical difficulty simply by arthroscopic surgery, making the tibial avulsionfracture of PCL easier.In addition,it increases the stressed area of the PCLand the avulsion fracture blocks,and makes the fixation more firmly by usingspiked spacer and cannulated screw via small incision behind knee under directvision.It is conducive to conduct knee joint function training early forpostoperative, and makes an early knee joint function recovery, the method isworthy of clinical popularization.