Arthroscopic single-tibial tunnel Pushlock fixation for tibial avulsion fracture of the posterior cruciate ligament: short-term outcomes

Objective To observe the short-term clinical outcomes of arthroscopic single-tibial tunnel Pushlock fixation in the treatment of tibial avulsion fracture of the posterior cruciate ligament (PCL). Methods From December 2015 to January 2018, 15 patients with tibial avulsion fracture of PCL were treated at Department of Articular Surgery, The Third Affiliated Hospital to Hebei Medical University. They were treated with arthroscopic single-tibial tunnel Pushlock fixation. All the fractures were fresh. They were 9 males and 6 females, aged from 14 to 64 years (average, 33.6 years). The short-term outcomes were evaluated by comparing their preoperative and postoperative flexion of the knee, International Knee Documentation Committee (IKDC) and Lysholm scores. Results The operation lasted from 40 to 70 minutes (average, 53 minutes). The 15 patients were successfully followed up for 10 to 18 months (average, 12.2 months). All the fractures united well within 3 months after operation. All the posterior drawer tests were negative, showing no displacements or no complications like lesions of popliteal fossa, nerves and vessels, or impaired knee extension. At 6 months after surgery, the knee flexion (123.4°±6.5°), the Lysholm scores (91.8±3.5) and the IKDC scores (95.5±1.6) were all significantly improved compared with the preoperative values (77.5°±13.1°, 46.8±8.9 and 37.0±8.9) (P<0.05). Conclusion The tibial avulsion fracture of PCL can be treated by arthroscopic single-tibial tunnel Pushlock fixation with satisfactory early outcomes. Key words: Posterior cruciate ligament; Tibial fracture; Arthroscopes; Pushlock