膝後十字靭帯脛骨付着部骨折に対する鏡視下骨接合術

概要

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In general, tibial bony avulsion fractures of the posterior cruciate ligament have been surgically treated using a direct posterior or posteromedial approach. These approaches provide excellent visua al fields and rigid fixation. However, it is difficult to investigate and treat other combined injuries in the knee joint because of the requisite prone position. In addition, there is fairly large surgical invasion due to extensive exposure of the popliteal lesion. Recently, treatments by the arthroscopic fixation of such fractures with good results have been reported. In this paper, we report 2 cases of tibial bony avulsion fracture. The 2 women patients were 56 and 61 years old, and had no combined injuries in the knee joints. The bony fragment sizes (15 mm×15mm) were fixed with a cannulated cancellous screw inserted from the anterior tibia aspect using a posteromedial arthroscopic view. The time to union was about 3 months in both cases. There were no clinical symptoms at 7 months after surgery. This technique can reduce the risk of injury to the posterior neurovascular complex and allow treatment of combined injuries in the knee joint. For these reasons, we conclude that arthroscopic internal fixation of tibial bony avulsion fracture using posteromedial view might be useful if the fragment size is large enough for screw fixation.
中国・四国整形外科学会の論文