C. Quintart et R. Elbaum, Isolated avulsion fracture of the tibial attachment of the posterior cruciate ligament in a twelve-year-old-girl, REV CHIR OR, 85(6), 1999, pp. 617-620
Citations number
12
Categorie Soggetti
Ortopedics, Rehabilitation & Sport Medicine
Journal title
REVUE DE CHIRURGIE ORTHOPEDIQUE ET REPARATRICE DE L APPAREIL MOTEUR
Purpose of the study The authors report one case of isolated avulsion fract
ure of the tibial attachment of the posterior cruciate ligament. They recom
mend the use of 3D CT Scan to appreciate the size, the displacement of the
bone fragment or the occurrence of comminuted fracture.
Material and method A 12 years old girl was admited for knee pain and swell
ing secondary to horse's hoof blow on the anterior aspect of the proximal t
ibia, Hemarthrosis, contusion of the anterior surface of the proximal tibia
were present. Because of pain and swelling, the knee could not be examinat
ed with accuracy. Roentgenographic examination showed isolated avulsion fra
cture of the tibial attachment of the posterior cruciate ligament. 3D CT Sc
an confirmed the lesion. Bony fragment was displaced and was not comminuted
. Approach through the popliteal fossa was used and bony fragment was screw
ed back into its bed.
Results Postoperatively, a long leg plaster of Paris was applied for 6 week
s. The patient was followed for 1.5 year. She returned to her previous occu
pation. There was no residual laxity. X ray confirmed fracture union.
Discussion Results of primary repair of interstitial posterior cruciate lig
ament tears were inconsistant. On the contrary, good functionnal results we
re obtained with surgically treated avulsion fracture of the posterior cruc
iate ligament. Displaced bony fragment will be fixed properly to its bed. 3
D CT Scan appreciate the size, the displacement or the occurrence of commin
uted fracture. Those informations help to define surgical procedure: screw,
wire-suture or staple.