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. 2015 Oct 23;50(6):631-7.
doi: 10.1016/j.rboe.2015.09.005. eCollection 2015 Nov-Dec.

Surgical treatment of avulsion fractures at the tibial insertion of the posterior cruciate ligament: functional result

Marcos Alexandre Barros  1 , Gabriel Lopes de Faria Cervone  1 , André Luis Serigatti Costa  1
Affiliations

Surgical treatment of avulsion fractures at the tibial insertion of the posterior cruciate ligament: functional result

Marcos Alexandre Barros et al. Rev Bras Ortop. .

Abstract
in English, Portuguese

Objective: To objectively and subjectively evaluate the functional result from before to after surgery among patients with a diagnosis of an isolated avulsion fracture of the posterior cruciate ligament who were treated surgically.

Method: Five patients were evaluated by means of reviewing the medical files, applying the Lysholm questionnaire, physical examination and radiological examination. For the statistical analysis, a significance level of 0.10 and 95% confidence interval were used.

Results: According to the Lysholm criteria, all the patients were classified as poor (<64 points) before the operation and evolved to a mean of 96 points six months after the operation. We observed that 100% of the posterior drawer cases became negative, taking values less than 5 mm to be negative.

Conclusion: Surgical methods with stable fixation for treating avulsion fractures at the tibial insertion of the posterior cruciate ligament produce acceptable functional results from the surgical and radiological points of view, with a significance level of 0.042.

Objetivo: Avaliar o resultado funcional pré e pós-cirúrgico, de forma objetiva e subjetiva, dos pacientes com diagnóstico de fratura avulsão isolada do ligamento cruzado posterior que foram tratados cirurgicamente.

Método: Foram avaliados cinco pacientes por meio de revisão de prontuários, aplicação do questionário de Lysholm, exame físico e exame radiológico. Para a estatística foi usado nível de significância de 0,10 e intervalo de confiança de 95%.

Resultados: Segundo os critérios de Lysholm, todos os pacientes foram classificados como ruins (< 64 pontos) no pré-operatório, evoluíram para média de 96 pontos em seis meses de pós-operatório. Observamos a negativação de 100% da gaveta posterior, uma vez que consideramos negativo o valor menor do que 5 mm.

Conclusão: A fratura avulsão do ligamento cruzado posterior na inserção tibial quando tratada com métodos cirúrgicos e fixação estável produz resultados funcionais aceitáveis do ponto de vista clínico e radiológico para uma significância de 0,042.

Keywords: Bone fractures; Knee; Posterior cruciate ligament.

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Figures

Fig. 1
Fig. 1
Simple radiography and computed tomography before the operation.
Fig. 2
Fig. 2
Technique used for radiography under stress at 80° of knee flexion, using 49 N on the ATT and radiological image.
Fig. 3
Fig. 3
Left: Trickey's route; and right: Burk's route.
Fig. 4
Fig. 4
Illustration of the distribution of the incision in the skin.
Fig. 5
Fig. 5
Radiography of synthesis in an adolescent, parallel to the growth plate, thus preserving it.
Fig. 6
Fig. 6
Illustration comparing times for applying Lysholm.
Fig. 7
Fig. 7
Illustration of the lesion distribution on the anterior face.
Fig. 8
Fig. 8
Image of extensive cutting-bruising wound and suturing in the anterior region of the lower leg.
See this image and copyright information in PMC

References

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