Clin Orthop Surg.  2015 Dec;7(4):505-508. 10.4055/cios.2015.7.4.505.

Suture Bridge Fixation Technique for Posterior Cruciate Ligament Avulsion Fracture

Affiliations
  • 1Department of Orthopedic Surgery, Eulji University School of Medicine, Daejeon, Korea. vyds123@eulji.ac.kr

Abstract

We presented a surgical technique including a suture bridge technique with relatively small incision for the reduction and fixation of posterior ligament avulsion fractures. A suture anchor was used to hold the avulsed fragment and a knotless anchor was used to continuously compress the bony fragment into the fracture site, thereby maintaining reduction during healing.

Keyword

Knee; Posterior cruciate ligament; Avulsion fracture; Posteromedial incision; Suture bridge technique

MeSH Terms

Adolescent
Adult
Humans
Knee Injuries/*surgery
Male
Posterior Cruciate Ligament/*injuries/*surgery
*Suture Anchors
*Suture Techniques
Young Adult

Figure

  • Fig. 1 Posterior view of the right knee. (A) An oblique incision between semitendinosus tendon and medial head of the gastrocnemius. (B) The medial head of the gastrocnemius (arrow) is held laterally to expose the posterior capsule of the knee joint. Subsequently, capsulotomy with a longitudinal L-shaped incision is made and extended laterally to expose the fracture site. The forceps hold a bony fragment of the posterior cruciate ligament tibial attachment. (C) Fixation technique of the suture bridge method, with proximal to the left and distal to the right of the photo. (D) Illustration showing the position of the anchors in the coronal plane. (E) Illustration showing the position of the anchors in the sagittal plane.

  • Fig. 2 Preoperative lateral simple radiograph (A) and computed tomography scan (B) of displaced posterior cruciate ligament avulsion fracture in a 20-year-old male. The arrow shows the bony fragment of posterior cruciate ligament avulsion fracture. (C) Postoperative lateral radiograph showing a healed avulsion fracture after surgical treatment using a suture bridge technique.

  • Fig. 3 (A) Preoperative lateral radiograph of displaced posterior cruciate ligament avulsion fracture in a 13-year-old male. The arrow shows the bony fragment of posterior cruciate ligament avulsion fracture. (B) Preoperative magnetic resonance imaging scan showing a thinner bone fragment. (C, D) Intraoperative fluoroscopic views showing the position of the anchors inserted so as not to penetrate a physeal plate. (E) Postoperative lateral radiograph showing the healed avulsion fracture after surgical treatment using a suture bridge technique.


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