Summary

A minimally invasive transverse incision is an effective surgical technique to fix posterior cruciate ligament avulsion fractures over its tibial attachment provided the surgeon has good understanding of the anatomy of the posterior aspect

Abstract

Background

Posterior cruciate ligament injuries are not as common as anterior cruciate ligament injuries with avulsion injuries over the tibial attachment of posterior cruciate ligament being even more uncommon . Avulsion fractures are traditional fixed by a large incision which increases pain and affects rehabilitation.

Purpose

A minimally invasive approach to fix posterior cruciate ligament avulsion injuries using basic instruments.

Materials And Methods

Single centre single surgeon study. The study included 12 males and 4 females. The mean follow-up period was 36.12 months . Fixation was done through a transverse incision over the posterior knee crease. Fixation was done with cannulated cancellous screws..

Results

There was a significant improvement in the Lysholm score (from a mean of 7.6 before surgery to 93.6 after surgery). This improvement was statistically significant as tested by Wilcoxon Signed Ranks Test. All the patients achieved a good range of knee flexion at final follow-up (mean of 126 degrees) with no posterior sag. Radiological union at fracture site was noted in all the cases.

Conclusion

A minimally invasive transverse incision is an effective surgical technique to fix posterior cruciate ligament avulsion fractures over its tibial attachment provided the surgeon has good understanding of the anatomy of the posterior aspect. This technique helps us to avoid the traditional large incisions which were used to fix these fractures and thus, improves the post-operative outcome and reduces the morbidity.
Keywords : Knee; posterior cruciate ligament; avulsion injury; minimally invasive; novel technique