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Two Cases of Contact Anterior Cruciate Ligament Rupture Combined with a Posterolateral Tibial Plateau Fracture.

Jiang L, Wu H, Yan S - Case Rep Orthop (2015)

Bottom Line: Findings.A posterolateral tibia plateau approach was used to reduce and fix the fractured area with the aid of lag screws.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Orthopaedics, The 2nd Affiliated Hospital, Medical College, Zhejiang University, Jiefang Road, No. 88, Hangzhou, Zhejiang, China.

ABSTRACT
Background. The combined occurrence of ACL rupture with a posterolateral tibial plateau fracture has not yet been reported. Two cases of such injuries have been treated in our department for the past three years. Findings. The two patients both suffered injuries from traffic accidents. The radiological examinations showed a ruptured ACL with fracture of the posterolateral tibial plateau. Reconstruction of the ACL was performed via a standard anatomical single bundle ACL reconstruction technique with autologous tendon by arthroscopy. A posterolateral tibia plateau approach was used to reduce and fix the fractured area with the aid of lag screws. After a one-year follow-up, the two patients recovered well and physical examinations showed full knee range of motion with no evidence of ACL instability. Conclusions. The cause of this type injury of ACL rupture with a posterolateral tibial plateau fracture was thought to be by a violent internal tibial rotation/anterior tibial translation without any valgus or varus knee force mechanism during the accident. Satisfactory clinical results were achieved with a standard anatomical single bundle ACL reconstruction by arthroscopy and ORIF for the posterolateral plateau fracture. Both patients reported excellent knee function and fracture healing.

No MeSH data available.


Related in: MedlinePlus

X-ray images of the knees after the operation. In the first patient (a), button steel was used at the femoral site for ACL reconstruction and two lag screws were used for posterolateral tibial fracture fixation. In the second patient (b), similar procedure to that for the first patient, but only one screw, was used. (c and d) The CT scans in patient one showed the tibial plateau fracture was well reduced and fixed.
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fig3: X-ray images of the knees after the operation. In the first patient (a), button steel was used at the femoral site for ACL reconstruction and two lag screws were used for posterolateral tibial fracture fixation. In the second patient (b), similar procedure to that for the first patient, but only one screw, was used. (c and d) The CT scans in patient one showed the tibial plateau fracture was well reduced and fixed.

Mentions: In these patients, ACL reconstructions were performed via a standard anatomical single bundle ACL reconstruction technique with autologous hamstring tendon by arthroscopy. A posterolateral tibia plateau approach was used for the fixation of lag screws for the posterolateral plateau fracture (Figure 3). The fibular nerve and popliteus tendon should be carefully protected during the approach. The fractures were easily reduced and the screws were inserted into the cartilage.


Two Cases of Contact Anterior Cruciate Ligament Rupture Combined with a Posterolateral Tibial Plateau Fracture.

Jiang L, Wu H, Yan S - Case Rep Orthop (2015)

X-ray images of the knees after the operation. In the first patient (a), button steel was used at the femoral site for ACL reconstruction and two lag screws were used for posterolateral tibial fracture fixation. In the second patient (b), similar procedure to that for the first patient, but only one screw, was used. (c and d) The CT scans in patient one showed the tibial plateau fracture was well reduced and fixed.
© Copyright Policy - open-access
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4510118&req=5

fig3: X-ray images of the knees after the operation. In the first patient (a), button steel was used at the femoral site for ACL reconstruction and two lag screws were used for posterolateral tibial fracture fixation. In the second patient (b), similar procedure to that for the first patient, but only one screw, was used. (c and d) The CT scans in patient one showed the tibial plateau fracture was well reduced and fixed.
Mentions: In these patients, ACL reconstructions were performed via a standard anatomical single bundle ACL reconstruction technique with autologous hamstring tendon by arthroscopy. A posterolateral tibia plateau approach was used for the fixation of lag screws for the posterolateral plateau fracture (Figure 3). The fibular nerve and popliteus tendon should be carefully protected during the approach. The fractures were easily reduced and the screws were inserted into the cartilage.

Bottom Line: Findings.A posterolateral tibia plateau approach was used to reduce and fix the fractured area with the aid of lag screws.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Orthopaedics, The 2nd Affiliated Hospital, Medical College, Zhejiang University, Jiefang Road, No. 88, Hangzhou, Zhejiang, China.

ABSTRACT
Background. The combined occurrence of ACL rupture with a posterolateral tibial plateau fracture has not yet been reported. Two cases of such injuries have been treated in our department for the past three years. Findings. The two patients both suffered injuries from traffic accidents. The radiological examinations showed a ruptured ACL with fracture of the posterolateral tibial plateau. Reconstruction of the ACL was performed via a standard anatomical single bundle ACL reconstruction technique with autologous tendon by arthroscopy. A posterolateral tibia plateau approach was used to reduce and fix the fractured area with the aid of lag screws. After a one-year follow-up, the two patients recovered well and physical examinations showed full knee range of motion with no evidence of ACL instability. Conclusions. The cause of this type injury of ACL rupture with a posterolateral tibial plateau fracture was thought to be by a violent internal tibial rotation/anterior tibial translation without any valgus or varus knee force mechanism during the accident. Satisfactory clinical results were achieved with a standard anatomical single bundle ACL reconstruction by arthroscopy and ORIF for the posterolateral plateau fracture. Both patients reported excellent knee function and fracture healing.

No MeSH data available.


Related in: MedlinePlus