BACKGROUND Independent avulsion fractures with anterior cruciate ligament(ACL)or posterior cruciate ligament(PCL)attachment are relatively common among tibial intercondylar eminence fractures,and their postoperative o...BACKGROUND Independent avulsion fractures with anterior cruciate ligament(ACL)or posterior cruciate ligament(PCL)attachment are relatively common among tibial intercondylar eminence fractures,and their postoperative outcomes are generally favorable.Conversely,huge avulsion fractures of the intercondylar eminence containing the attachment site of both the ACL and the PCL are extremely rare,and the reported clinical outcomes are poor.CASE SUMMARY We describe a 30-year-old Japanese male's huge avulsion fracture of the intercondylar eminence of a tibia containing the attachment site of both the ACL and PCL,together with a complete tear of the medial collateral ligament and a partial tear of both the medial and lateral menisci caused by a fall from a high place.All of these injuries were treated surgically,with anatomical reduction and stable fixation.The limb function at 1 year post-surgery was excellent(Lysholm score:100 points).CONCLUSION Although this patient's complete surgical repair was complex,it should be performed in similar cases for an excellent final clinical outcome.展开更多
Introduction: results after non-operative management for knees sustaining combined acute anterior and posterior cruciate ligament tears were presented. Subjects: 13 patients, 10 with medial, and 3 with lateral ligamen...Introduction: results after non-operative management for knees sustaining combined acute anterior and posterior cruciate ligament tears were presented. Subjects: 13 patients, 10 with medial, and 3 with lateral ligament injury. Methods: non-operative management consisted of employing a brace to prevent sagittal translation of the tibia. Quadriceps muscle and early passive knee motion exercises in the brace was encouraged immediately after arthroscopy. Weight-bearing was forbidden for 3 weeks. The brace was not removed for 3 months. Follow-up periods ranged from 2 to 6 years (mean, 3 years 2 months). Results: none, but one patient had a slight restriction of knee flexion. Quadriceps muscle strength revealed an average of 89.0% of normal side. The knee score indicated 2 patients rated good, 3 rated fair, and 8 rated poor. The score correlated with measurements of anterior and posterior translation on the stress radiograph significantly. Stress radiography revealed that anterior laxity was reduced better than posterior laxity significantly. Conclusion: non-operative brace therapy can be considered for this combined injury as the initial treatment. A late reconstruction would be performed when the result was not satisfactory. Preserved range of motion and muscle strength after brace therapy had a great advantage to the late reconstructive surgery.展开更多
文摘BACKGROUND Independent avulsion fractures with anterior cruciate ligament(ACL)or posterior cruciate ligament(PCL)attachment are relatively common among tibial intercondylar eminence fractures,and their postoperative outcomes are generally favorable.Conversely,huge avulsion fractures of the intercondylar eminence containing the attachment site of both the ACL and the PCL are extremely rare,and the reported clinical outcomes are poor.CASE SUMMARY We describe a 30-year-old Japanese male's huge avulsion fracture of the intercondylar eminence of a tibia containing the attachment site of both the ACL and PCL,together with a complete tear of the medial collateral ligament and a partial tear of both the medial and lateral menisci caused by a fall from a high place.All of these injuries were treated surgically,with anatomical reduction and stable fixation.The limb function at 1 year post-surgery was excellent(Lysholm score:100 points).CONCLUSION Although this patient's complete surgical repair was complex,it should be performed in similar cases for an excellent final clinical outcome.
文摘Introduction: results after non-operative management for knees sustaining combined acute anterior and posterior cruciate ligament tears were presented. Subjects: 13 patients, 10 with medial, and 3 with lateral ligament injury. Methods: non-operative management consisted of employing a brace to prevent sagittal translation of the tibia. Quadriceps muscle and early passive knee motion exercises in the brace was encouraged immediately after arthroscopy. Weight-bearing was forbidden for 3 weeks. The brace was not removed for 3 months. Follow-up periods ranged from 2 to 6 years (mean, 3 years 2 months). Results: none, but one patient had a slight restriction of knee flexion. Quadriceps muscle strength revealed an average of 89.0% of normal side. The knee score indicated 2 patients rated good, 3 rated fair, and 8 rated poor. The score correlated with measurements of anterior and posterior translation on the stress radiograph significantly. Stress radiography revealed that anterior laxity was reduced better than posterior laxity significantly. Conclusion: non-operative brace therapy can be considered for this combined injury as the initial treatment. A late reconstruction would be performed when the result was not satisfactory. Preserved range of motion and muscle strength after brace therapy had a great advantage to the late reconstructive surgery.
