Compare The Clinical Efficacy Of Under Arthroscopy And Small Incision In The Treatment Of PCL Avulsion Fracture Of Tibia

Objective: To compare the clinical efficacy of double ETHIBOND line for two tibial tunneling under arthroscopy and small incision wire anchor in the treatment of Posterior cruciate ligament(PCL)avulsion fracture.Methods: A retrospective analysis was performed on 55 cases of PCL avulsion fracture at the tibial point admitted to our hospital from December 2013 to August 2018.28 cases(21 males and 7 females)in the arthroscopic group(A1 group),with an average age of(35.1±11.5)years old,were treated with total arthroscopic posterior and posterolateral approaches combined with double ETHIBOND line.27 cases(21 males and 6 females)in the open group(A2group),with an average age(30.1±9.8)years old,were treated with a small posterior medial genicular incision combined with 1-2 anchors to reduce the bone mass.Observe and compare the operation time,postoperative fracture reduction,healing,incision infection,Posterior drawer test and other conditions of the two groups.Knee function scores were compared preoperatively,postoperatively at 3 months and at the last follow-up,respectively,by knee range of motion,Tegner level score,Lysholm score and IKDC score.Results: 55 patients in both groups were followed up for an average of30.6 months.The mean operation time of A1 group(119.29±28.09)min was significantly different from that of A2 group(90.03±19.86)min.The second day after surgery,all fractures were reexamined by X-ray and CT with satisfactory reduction and no displacement.3 months after the operation,1 patient in group A2 received X-ray reexamination,whose fracture healing was poor.1 case of superficial oral infection was found in both groups.The last follow-up,in A1 group has 2 cases is PDT(+),in A2 group has 1 case is PDT(+),A2 group 1case is built residual 15 ° lateral buckling limited.The last follow-up of A1 group average(135.86±4.30)°knee range of motion and A2 group average(136.44±3.03)° is not significant,two groups compared with preoperative significant differences(P < 0.05).After 3 months of two groups of Tegner activity levels,the Lysholm knee score and IKDC scores a preoperative were significantly improved,the difference had statistical significance(P < 0.05),two groups at the time of the last follow-up the Tegner activity levels grading,Lysholm scale and IKDC scores compared with postoperative 3 months were statistically significant(P < 0.05),but no statistical differences were compared between the two way.Conclusion: Satisfactory and safe clinical efficacy can be obtained in the treatment of PCL avulsion fracture of tibia by two surgical methods.The arthroscopy group not noly had less trauma,direct monitoring and no need to open the joint capsule,but Intra-articular injuries can be managed,the material of ETHIBOND was cheaper than anchor nail.But the operation time of the opengroup was short,the operation was more simple,and the early functional exercise of the affected knee could be guaranteed.