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Abstract Objective To compare the clinical outcome of arthroscopic reduction and internal fixation(ARIF) through ultrahigh posteromedial portal and mini-open reduction and internal fixation(ORIF) for avulsion fracture of the tibial attachment of the posterior cruciate ligament(PCL).Methods From March 2011 to March 2017，68 cases of the avulsion fracture of Posterior Cruciate Ligament were treated operatively in our hospital.Thirty-three patients were treated with ARIF through ultrahigh posteromedial portal (Group A).Thirty-five patients were treated with ORIF with cannulated screws (Group B).There were 20 males and 13 females in group A，with a mean age of (30.2±2.1)years old，and 25 males and 10 females in group B，with a mean age of (28.3±3.6)years old.The PCL and avulsion bony fragment were fixed with 4.0 mm canulated screw (Synthes).The outcome were measured by X-ray，CT or MRI testing.Patients were available for clinical evaluation with KT-2000 arthrometer measurements and PDT tests，and knee function with the Intemational Knee Documentation Committee(IKDC)，Lysholm scores.Results All the patients were followed up at an averge of 12～18 months.Primary union were achieved in all the fractures 3 months postoperatively.The average time of operations were (65.51±4.83)min in Group A and (45.36±3.29)min in Group B.There were no significant differences between group A and group B regarding the PDT negative rate (87.9％ versus 91.4％)，the Lysholm score (95.51±4.83 versus 96.40±3.78)，the IKDC score (93.34±3.61 versus 95.67±5.44).There were no significant differences between the surgical knee and the normal knee regarding the the results of KT-2000 at the tensile fore of 134 N，Group A：(2.47±1.02)mm vs (2.05±0.92)mm，Group B：(2.53±0.82)mm vs (2.24±0.73)mm at 90° of flexion.There were no significant differences between Group A and Group B of the surgical knee regarding the the results of KT-2000 (2.47±1.02)mm vs (2.53±0.82)mm at 90°of flexion.Conclusion The treatment of the avulsion fracture of PCL with ultrahigh posteromedial portal under arthroscopy is a reliable technique，both arthroscopy and mini-incision surgery can achieve satisfactory clinical outcomes，but mini-open reduction and internal fixation(ORIF) can result in much shorter operative time and thus permit an early postoperative rehabilitation.
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Wang Xinmin,Liu Fei,Zhao Haixia, et al. Comparison of Arthroscopic Treatment through Ultrahigh Posteromedial Portal Versus Mini-open Reduction and Internal Fixation for Avulsion Fracture of the Tibial Attachment of the Posterior Cruciate Ligament[J]. sygkzz, 2018, 24(1): 19-24.
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| http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2018/V24/I1/19 |
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