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Title: [A comparative study of absorbable screw fixation and absorbable screw combined with suture anchor fixation in treatment of avulsion fracture of posterior cruciate ligament at tibial insertion of knee joint].
Author: Wu S, Zhang K, Fu W, Li J.
Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi; 2023 May 15; 37(5):572-577. PubMed ID: 37190834.
Abstract:
OBJECTIVE: To compare the effectiveness of open reduction of posterior cruciate ligament (PCL) avulsion fracture at tibial insertion of knee joint with absorbable screws fixation and absorbable screw combined with suture anchor fixation. METHODS: The clinical data of 26 patients with PCL avulsion fracture at tibial insertion who met the selection criteria between March 2015 and October 2021 were retrospectively analyzed. Among them, 14 patients were fixed with simple absorbable screw (group A), and 12 patients were fixed with absorbable screw combined with suture anchors (group B). All patients were confirmed by X-ray film, CT, or MRI preoperatively, and got positive results in preoperative posterior drawer tests. There was no significant difference in gender, age, side of affected limb, time from injury to operation, comorbidities, and preoperative Meyers & McKeever classification, Lysholm score, and International Knee Documentation Committee (IKDC) score between the two groups ( P>0.05). The operation time and postoperative complications were recorded and compared between the two groups. At last follow-up, Lysholm score and IKDC score were used to evaluate the improvement of knee function. RESULTS: There was no significant difference in operation time between the two groups ( P>0.05). All incisions healed by first intention, and no complication such as vascular and nerve injury or venous thrombosis occurred. All 26 patients were followed up 9-89 months, with an average of 55.3 months. The follow-up time of group A and group B was (55.7±23.2) and (56.8±29.3) months, respectively, with no significant difference ( t=-0.106, P=0.916). Radiographs showed bone healing in both groups at 3 months after operation, and no complication such as infection and traumatic arthritis occurred. At last follow-up, the posterior drawer test was negative in both groups, and the Lysholm score and IKDC score significantly improved when compared with the pre-operative values ( P<0.05). However, there was no significant difference in the improvement value between the two groups ( P>0.05). CONCLUSION: For PCL avulsion fracture at tibial insertion of the knee joint, the open reduction and absorbable screw combined with suture anchor fixation can achieve reliable fracture reduction and fixation, which is conducive to the early rehabilitation and functional exercise, and the postoperative functional recovery of the knee joint is satisfactory. 目的: 比较膝关节后交叉韧带（posterior cruciate ligament，PCL）胫骨止点撕脱骨折切开复位单纯可吸收螺钉固定与可吸收螺钉联合带线锚钉固定治疗的临床疗效。. 方法: 回顾性分析2015年3月—2021年10月收治的26例符合选择标准的PCL胫骨止点撕脱骨折患者临床资料，其中14例采用单纯可吸收螺钉固定（A组），12例采用可吸收螺钉联合带线锚钉固定（B组）。所有患者均由术前X线片、CT、MRI及术中确诊，术前后抽屉试验均为阳性。两组患者性别、年龄、患肢侧别、受伤至手术时间、合并症及术前Meyers & McKeever分型、Lysholm评分和国际膝关节文献委员会（IKDC）评分等基线资料比较差异均无统计学意义（ P>0.05）。记录并比较两组手术时间及术后并发症发生情况；末次随访时，采用Lysholm 评分、IKDC评分评价膝关节功能改善情况。. 结果: 两组患者手术时间比较差异无统计学意义（ P>0.05）。所有患者切口均Ⅰ期愈合，无血管、神经损伤或静脉血栓形成等早期并发症发生。26例患者均获随访，随访时间9～89个月，平均55.3个月；其中A、B组随访时间分别为（55.7±23.2）和（56.8±29.3）个月，差异无统计学意义（ t=−0.106， P=0.916）。术后3个月影像学复查示骨折均愈合，无感染、创伤性关节炎等并发症发生。末次随访时，两组患者后抽屉试验均为阴性。Lysholm 评分、IKDC 评分均较术前明显改善，差异有统计学意义（ P<0.05）；但两组间评分改善值比较差异均无统计学意义（ P>0.05）。. 结论: 切开复位、可吸收螺钉联合带线锚钉固定治疗膝关节PCL胫骨止点撕脱骨折，骨折复位固定牢靠，利于早期康复功能锻炼，术后膝关节功能恢复满意。.

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