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Zhongguo Xiu Fu Chong Jian Wai Ke Za... Mar 2024To investigate the effectiveness of arthroscopic suspension fixation with Endobutton in the treatment of tibial insertion avulsion fractures of posterior cruciate...
OBJECTIVE
To investigate the effectiveness of arthroscopic suspension fixation with Endobutton in the treatment of tibial insertion avulsion fractures of posterior cruciate ligament (PCL).
METHODS
A retrospective analysis was conducted on the clinical data of 52 patients (52 knees) with tibial insertion avulsion fractures of PCL, who were treated by arthroscopic suspension fixation with Endobutton between June 2017 and October 2022. There were 29 males and 23 females, with an average age of 40.6 years (range, 19-66 years). There were 24 cases of traffic accident injuries, 17 cases of sports injuries, and 11 cases of fall injuries. The time from injury to operation ranged from 6 to 19 days (mean, 13.3 days). According to the Meyers-McKeever classification, there were 30 cases of type Ⅱ and 22 cases of type Ⅲ fractures. All patients exhibited positive posterior drawer test results. Preoperative knee joint function was assessed with Lysholm score (21.3±6.7), International Knee Documentation Committee (IKDC) score (20.7±5.8), and visual analogue scale (VAS) score (5.3±0.7); and knee joint range of motion was (41.73±3.17)°. Based on preoperative CT three-dimensional reconstruction measurements, the longitudinal diameter of the avulsed bone fragment ranged from 13 to 25 mm (mean, 18.1 mm). Operation time and occurrence of complications were recorded, and postoperative imaging was used to assess fracture healing. Knee joint function and pain severity were evaluated using knee joint range of motion, Lysholm score, IKDC score, and VAS score.
RESULTS
The operation time ranged from 46 to 81 minutes (mean, 56.2 minutes). All patients were followed up 12-28 months (mean, 20.1 months). The iatrogenic fractures of bone fragments occurred during operation in 4 cases; and knee effusion occurred in 2 cases and anterior knee pain in 1 case after operation. All incisions healed by first intention. Imaging evaluations at 3 months after operation showed the fracture healing and no internal fixation failure. All patients demonstrated good knee function and had returned to normal activities at 12 months after operation. At last follow-up, the knee joint range of motion was (133.44±4.17)°, Lysholm score 93.6±3.1, IKDC score 93.4±2.5, and VAS score 1.0±0.6, with significant differences compared to preoperative scores ( <0.05).
CONCLUSION
Arthroscopic suspension fixation with Endobutton in the treatment of tibial insertion avulsion fractures of PCL is simple to operate, and the knee joint function recovers well.
Topics: Male; Female; Humans; Adult; Posterior Cruciate Ligament; Anterior Cruciate Ligament; Fractures, Avulsion; Retrospective Studies; Anterior Cruciate Ligament Injuries; Treatment Outcome; Arthroscopy; Suture Techniques; Knee Joint; Tibial Fractures
PubMed: 38500417
DOI: 10.7507/1002-1892.202401028 -
BMC Surgery Mar 2024Skier's thumb is a type of injury to the ulnar collateral ligament of the metacarpophalangeal joint of the thumb, which can result in bone fragmentation and joint...
BACKGROUND
Skier's thumb is a type of injury to the ulnar collateral ligament of the metacarpophalangeal joint of the thumb, which can result in bone fragmentation and joint instability.
OBJECTIVE
The objective of this study was to compare the traditional Kirschner wire fixation method with the U-shaped Kirschner wire method for treating small bone fragments with displacement, rotation, or instability in skier's fractures.
METHOD
A retrospective study was conducted on 30 patients with skier's thumb who were treated at Tianjin Hospital from January 2019 to December 2021. Patients were divided into two groups: Group A received traditional Kirschner wire fixation, while Group B received U-shaped Kirschner wire fixation. Functional assessments and complications during the perioperative period were evaluated.
RESULTS
Both surgical methods significantly reduced postoperative pain and increased joint range of motion. Group B had a lower incidence of pain during follow-up and showed significant functional improvement in Tip-pinch and Grip tests compared to Group A. U-shaped Kirschner wire fixation significantly reduced complications during the perioperative period.
CONCLUSION
The U-shaped Kirschner wire internal fixation is a safe and effective treatment for the thumb proximal phalanx base ulnar side avulsion fracture.
Topics: Humans; Thumb; Bone Wires; Retrospective Studies; Treatment Outcome; Fractures, Bone; Finger Injuries; Fracture Fixation, Internal; Soft Tissue Injuries
PubMed: 38491501
DOI: 10.1186/s12893-024-02382-7 -
International Journal of General... 2024Cervical hyperextension injury is very frequent with anterior longitudinal ligament (ALL) injury, and the ligament damage has a remarkable effect on whether and what...
BACKGROUND AND AIM
Cervical hyperextension injury is very frequent with anterior longitudinal ligament (ALL) injury, and the ligament damage has a remarkable effect on whether and what type of operation should be performed. This study aims to establish a new scoring system for the accurate diagnosis of ALL damage.
METHODS
The imaging data of the consecutive patients was measured and scored by four radiologists. Intraoperative exploration was performed by three surgeons. The crude and adjusted odds ratios (cOR and aOR) and receiver operating characteristic curve (ROC) were constructed to assess the diagnostic accuracy of the scoring system.
RESULTS
A total of 255 patients with cervical spine trauma were included in this study. There was no statistical difference in the relationship between demographics and ALL injuries (P > 0.05). Thickness of prevertebral soft tissue (aOR = 11.922, P = 0.004), intervertebral disk angle (aOR = 13.21, P = 0.002), avulsion fracture of the anterior edge of the vertebral body (aOR = 13.844, P = 0.029), ALL disrupted in T1-weighted sequence (aOR = 18.349, P < 0.001), and high signal area in T2-weighted sequence (aOR = 20.898, P = 0.002) had significantly higher diagnostic accuracy. The scoring system's sensitivity and specificity were 94.0% and 88.1%, respectively, and the accuracy was 90.8%.
CONCLUSION
The study established a new scoring system for ALL injuries based on the analysis of a series of clinical data and statistics. A total of five scoring items, a total score of 7 points, and an ALL injury may be diagnosed when the score is not less than 3 points. This scoring system enables an efficient and accurate diagnosis of all injuries.
PubMed: 38481615
DOI: 10.2147/IJGM.S446004 -
Trauma Case Reports Apr 2024Bony avulsion injuries of the triangular fibrocartilage complex (TFCC) caused by penetrating wrist trauma are rare, and there is limited literature available regarding...
Bony avulsion injuries of the triangular fibrocartilage complex (TFCC) caused by penetrating wrist trauma are rare, and there is limited literature available regarding their treatment. This case report describes a 54-year-old male who sustained a penetrating injury to his right wrist, resulting in "double lesion" of TFCC injury, which are ulnar avulsion (Palmer 1B) and radial avulsion (Palmer 1D) lesion with a sigmoid notch fracture. The patient underwent an arthroscopic examination and a novel arthroscopic technique for fixation and repair of the TFCC injury. The procedure involved debridement, repair of the dorsal radioulnar ligament bony avulsion, and fixation of the foveal bony avulsion of the TFCC. The patient's wrist was immobilized postoperatively, followed by gradual rehabilitation. At the final follow-up of six months, the patient demonstrated improved range of motion and functional outcomes. This case report highlights the successful use of arthroscopic techniques for the treatment of complex TFCC avulsion injuries resulting from penetrating wrist trauma.
PubMed: 38464486
DOI: 10.1016/j.tcr.2024.100986 -
Arthroscopy Techniques Feb 2024Arthroscopic or open surgical treatment is indicated for displaced tibial spine fractures to obtain anatomic reduction and restore the functionality of the anterior...
Arthroscopic or open surgical treatment is indicated for displaced tibial spine fractures to obtain anatomic reduction and restore the functionality of the anterior cruciate ligament. Numerous open and arthroscopic techniques for the treatment of tibial spine fractures have been described. The purpose of this technical note is to describe a minimally invasive arthroscopic physeal- and ligament-sparing surgical technique using knotless all-suture anchors to provide stable bridge fixation over displaced tibial spine fractures.
PubMed: 38435248
DOI: 10.1016/j.eats.2023.09.029 -
The Archives of Bone and Joint Surgery 2024We present a unique case of a 59-year-old shipyard worker who sustained an avulsion fracture of the tibialis anterior tendon, concurrently with a comminuted fracture at...
We present a unique case of a 59-year-old shipyard worker who sustained an avulsion fracture of the tibialis anterior tendon, concurrently with a comminuted fracture at the base of the first metatarsal. This is the first reported case highlighting this concomitant presentation, which underlines the possibility of avulsion fractures accompanying comminuted fractures. Importantly, such avulsion fractures could lead to skin tenting and potential necrosis, necessitating early identification and prompt intervention. The patient underwent successful surgical intervention and displayed good functional restoration 15 months postoperatively.
PubMed: 38420523
DOI: 10.22038/ABJS.2023.74692.3457 -
Journal of Orthopaedic Case Reports Feb 2024Distal pole of patella avulsion fracture with tibial tuberosity avulsion has been frequently reported as a bifocal patellar tendon injury. However, an osteochondral...
INTRODUCTION
Distal pole of patella avulsion fracture with tibial tuberosity avulsion has been frequently reported as a bifocal patellar tendon injury. However, an osteochondral lateral patella facet fracture with a longitudinal split in the patella tendon in addition to these avulsion fractures has never been documented previously. Hence, we now report this trifocal patellar tendon injury.
CASE REPORT
An adolescent with a trifocal patella tendon injury underwent a fixation with a combination of transosseous pull- through sutures, suture tape, and knotless anchor. The patient was rehabilitated with gradual increase in 30° of knee flexion weekly and has now attained full knee range of motion.
CONCLUSION
Fixation of the small avulsion fracture can be challenging using conventional methods such as cannulated cancellous screws especially in an immature skeleton as it can crush the fragments. Suture tape, transosseous tunnels, and knotless suture anchors have more flexibility, they avoid the physis and provide adequate strength in such situations compared to metallic implants.
PubMed: 38420242
DOI: 10.13107/jocr.2024.v14.i02.4250 -
Journal of Orthopaedic Case Reports Feb 2024Tibial tubercle avulsion fractures are a rare lesion in adolescence that occurs during sports such as basketball, soccer, and volleyball. They result from a forceful...
INTRODUCTION
Tibial tubercle avulsion fractures are a rare lesion in adolescence that occurs during sports such as basketball, soccer, and volleyball. They result from a forceful extension of the knee against a fixed leg.
CASE REPORT
Case 1: A 14-year-old adolescent who reportedly experienced severe knee pain when he jumped to head a ball during a soccer game. Case 2: A 17-year-old teenager who reportedly experienced severe knee pain on takeoff during a high jump event. Case 3: A 16-year-old who reportedly felt pain during takeoff to catch a basketball. Case 4: A 14-year-old adolescent who reportedly felt pain in his left knee on takeoff from a high jump during a basketball game. All of these patients presented with a defective leg extension on clinical examination. Radiographs showed an avulsion fracture of the anterior tibial tuberosity and treatment was surgical.
DISCUSSION
Avulsion fractures of the tibial tuberosity are rare lesions. They occur in adolescents during sports and are usually accompanied by fracture fragment displacement, indicating reduction, and internal fixation surgery by screwing. In the short term, the result is satisfactory.
CONCLUSION
Tibial tuberosity avulsion fractures when managed in their entirety, give better results with a precocious return to sport.
PubMed: 38420239
DOI: 10.13107/jocr.2024.v14.i02.4202 -
Cureus Jan 2024Ischial tuberosity avulsion fractures are overall uncommon but are known injuries in the adolescent population. They are the result of sudden, forceful contraction of...
Ischial tuberosity avulsion fractures are overall uncommon but are known injuries in the adolescent population. They are the result of sudden, forceful contraction of the hamstring muscle groups. The characteristic radiographic appearance of an ischial tuberosity avulsion fracture is of an irregular ischial margin and a nearby avulsed bone fragment. Callous formation may ensue and appears as a calcific density in the region of injury. Awareness of the spectrum of radiographic presentations can help ensure correct diagnosis and minimize concern for alternative underlying diagnoses. This case report describes a 14-year-old boy with a chronic ischial tuberosity avulsion fracture which demonstrated an unusual presentation on radiographs and required MRI to confirm the diagnosis and rule out other potentially ominous pathology.
PubMed: 38420073
DOI: 10.7759/cureus.53165 -
Cureus Jan 2024Traumatic globe luxation associated with optic nerve avulsion is rare. We describe a case of a 42-year-old Indian gentleman who was involved in a motor vehicle accident...
Traumatic globe luxation associated with optic nerve avulsion is rare. We describe a case of a 42-year-old Indian gentleman who was involved in a motor vehicle accident (MVA). He sustained a deep laceration wound from the right side of the nose extending to the left medial canthal region and left eyelid. The left globe was not visualized, and only the left optic nerve stump was seen. A computerized tomography (CT) scan showed a left globe dislocated inferotemporal with discontinuity of the left optic nerve, inferior rectus, and lateral rectus muscle. There were also comminuted fractures at the floor and lateral wall of the left orbit with significant lateral displacement of the bone fragments. He underwent left eye enucleation, toilet, and suturing of the laceration wounds and open reduction internal fixation (ORIF) of the fractures. We report this case as it is not commonly seen in Malaysia.
PubMed: 38420068
DOI: 10.7759/cureus.53150