A new ultrasound‐guided surgical technique to fix acute tibial posterior cruciate ligament avulsion fracture

Abstract Purpose This study aims to describe a novel minimally invasive technique for the treatment of acute tibial posterior cruciate ligament (PCL) avulsion fracture. Methods This retrospective study included seven patients who underwent ultrasound‐guided fixation for acute PCL tibial avulsion fra...

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Main Authors: Hao Luo, Lin‐Feng Li, Song Han, Yu Pan, Fei‐Ju Xu, Tao Liu
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Journal of Experimental Orthopaedics
Subjects:
Online Access:https://doi.org/10.1002/jeo2.70191
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author Hao Luo
Lin‐Feng Li
Song Han
Yu Pan
Fei‐Ju Xu
Tao Liu
author_facet Hao Luo
Lin‐Feng Li
Song Han
Yu Pan
Fei‐Ju Xu
Tao Liu
author_sort Hao Luo
collection DOAJ
description Abstract Purpose This study aims to describe a novel minimally invasive technique for the treatment of acute tibial posterior cruciate ligament (PCL) avulsion fracture. Methods This retrospective study included seven patients who underwent ultrasound‐guided fixation for acute PCL tibial avulsion fractures by using an adjustable‐loop device between January 2021 and January 2023. Before the surgery, the maximum diameter, area and displacement distance of the fragments were measured using computed tomography examination. All patients were followed up for at least 12 months, and clinical outcomes were assessed on the basis of range of motion, the International Knee Documentation Committee Score and the Lysholm score. Results For the seven patients, the mean maximum diameter, area and displacement distance of preoperative avulsion fragments were 12.7 mm (range, 9.0–48.3), 128 mm2 (range, 63–256.2) and 5.9 mm (range, 3.8–7.2), respectively. These fractures were fixed using an adjustable‐loop suspensory device under ultrasound guidance. Based on x‐ray examination during the post‐operative follow‐up period, all patients had no fracture displacement and fracture unions were confirmed, with a mean union time of 10.28 ± 2.13 weeks (range, 8–14). Based on the knee function assessment at 12‐month post‐operative follow‐up visit, all patients demonstrated excellent clinical outcomes. Conclusions Ultrasound‐assisted internal fixation using an adjustable‐loop device demonstrated satisfactory clinical and radiographic results. This technique has the advantages of being minimally invasive, safe, stable, convenient to operate and thus could be considered as a feasible alternative for the treatment of acute tibial PCL avulsion fractures. Level of Evidence Level III.
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spelling doaj-art-01d74bcee5e94f2a91f6f09fc08729842025-08-20T01:55:38ZengWileyJournal of Experimental Orthopaedics2197-11532025-01-01121n/an/a10.1002/jeo2.70191A new ultrasound‐guided surgical technique to fix acute tibial posterior cruciate ligament avulsion fractureHao Luo0Lin‐Feng Li1Song Han2Yu Pan3Fei‐Ju Xu4Tao Liu5Department of Orthopaedic Surgery The Affiliated People's Hospital of Jiangsu University Zhenjiang Jiangsu ChinaDepartment of Orthopaedic Southwest Hospital Jiangbei Area (The 958th Hospital of Chinese People's Liberation Army) Chongqing Sichuan ChinaDepartment of Orthopaedic Surgery The Affiliated People's Hospital of Jiangsu University Zhenjiang Jiangsu ChinaDepartment of Orthopaedic Surgery The Affiliated People's Hospital of Jiangsu University Zhenjiang Jiangsu ChinaDepartment of Ultrasound Medicine The Affiliated People's Hospital of Jiangsu University Zhenjiang Jiangsu ChinaDepartment of Orthopaedic Surgery The Affiliated People's Hospital of Jiangsu University Zhenjiang Jiangsu ChinaAbstract Purpose This study aims to describe a novel minimally invasive technique for the treatment of acute tibial posterior cruciate ligament (PCL) avulsion fracture. Methods This retrospective study included seven patients who underwent ultrasound‐guided fixation for acute PCL tibial avulsion fractures by using an adjustable‐loop device between January 2021 and January 2023. Before the surgery, the maximum diameter, area and displacement distance of the fragments were measured using computed tomography examination. All patients were followed up for at least 12 months, and clinical outcomes were assessed on the basis of range of motion, the International Knee Documentation Committee Score and the Lysholm score. Results For the seven patients, the mean maximum diameter, area and displacement distance of preoperative avulsion fragments were 12.7 mm (range, 9.0–48.3), 128 mm2 (range, 63–256.2) and 5.9 mm (range, 3.8–7.2), respectively. These fractures were fixed using an adjustable‐loop suspensory device under ultrasound guidance. Based on x‐ray examination during the post‐operative follow‐up period, all patients had no fracture displacement and fracture unions were confirmed, with a mean union time of 10.28 ± 2.13 weeks (range, 8–14). Based on the knee function assessment at 12‐month post‐operative follow‐up visit, all patients demonstrated excellent clinical outcomes. Conclusions Ultrasound‐assisted internal fixation using an adjustable‐loop device demonstrated satisfactory clinical and radiographic results. This technique has the advantages of being minimally invasive, safe, stable, convenient to operate and thus could be considered as a feasible alternative for the treatment of acute tibial PCL avulsion fractures. Level of Evidence Level III.https://doi.org/10.1002/jeo2.70191Adjustable‐loop cortical buttonPosterior cruciate ligamentSuspensory fixationTibial avulsion fractureUltrasound
spellingShingle Hao Luo
Lin‐Feng Li
Song Han
Yu Pan
Fei‐Ju Xu
Tao Liu
A new ultrasound‐guided surgical technique to fix acute tibial posterior cruciate ligament avulsion fracture
Journal of Experimental Orthopaedics
Adjustable‐loop cortical button
Posterior cruciate ligament
Suspensory fixation
Tibial avulsion fracture
Ultrasound
title A new ultrasound‐guided surgical technique to fix acute tibial posterior cruciate ligament avulsion fracture
title_full A new ultrasound‐guided surgical technique to fix acute tibial posterior cruciate ligament avulsion fracture
title_fullStr A new ultrasound‐guided surgical technique to fix acute tibial posterior cruciate ligament avulsion fracture
title_full_unstemmed A new ultrasound‐guided surgical technique to fix acute tibial posterior cruciate ligament avulsion fracture
title_short A new ultrasound‐guided surgical technique to fix acute tibial posterior cruciate ligament avulsion fracture
title_sort new ultrasound guided surgical technique to fix acute tibial posterior cruciate ligament avulsion fracture
topic Adjustable‐loop cortical button
Posterior cruciate ligament
Suspensory fixation
Tibial avulsion fracture
Ultrasound
url https://doi.org/10.1002/jeo2.70191
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