KMID : 1037920210080020061
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Arthroscopy and Orthopedic Sports Medicine 2021 Volume.8 No. 2 p.61 ~ p.66
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Arthroscopic modular suspensory fixation of posterior cruciate ligament tibial avulsion fracture: a novel technique
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Jie Joel Lee Zhao
Wang Lushun
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Abstract
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Displaced posterior cruciate ligament (PCL) tibial avulsion fractures lead to knee instability and often require anatomic reduction and fixation to restore function. We describe an arthroscopic modular suspensory fixation method using a novel double Endobutton construct. The patient was a 42-year-old male who sustained the above injury in a motorcycle accident. Radiographic imaging showed a displaced fragment measuring 3.1 cm ¡¿ 2.6 cm ¡¿ 1.5 cm. The patient subsequently underwent arthroscopic surgical fixation 13 days after the initial injury. Standard and posteromedial arthroscopic portals were created and the fragment was reduced with a tibial PCL drill guide and temporarily held by a 2.4-mm guidewire. Subsequently, a double Endobutton construct, which was created with two UltraTapes, a 10-mm titanium ULTRABUTTON, and a 15-mm round titanium XTENDOBUTTON that was introduced, tightened, and fixed distally with another round 15-mm XTENDOBUTTON as well as a suture anchor augmentation. The patient recovered well and was last reviewed in the clinic 8 weeks postoperatively with a good clinical outcome. The authors believe that this novel modification to the previously established transtibial all-inside Endobutton technique allows for the optimal distribution of compression pressure and reduces the risk of button pull through and should be considered in such cases in the future.
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KEYWORD
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Posterior cruciate ligament reconstruction, Arthroscopy, Avulsion fracture
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