| Background: Posterior cruciate ligament（PCL）injuries are common in knee joints,but PCL tibial insertion avulsion fractures are relatively uncommon.The primary function of the PCL is to limit the movement of the tibia.Incorrect treatment of a PCL injury can result in knee active pain,traumatic arthritis,joint fibrosis,and other complications.Due to the anatomical characteristics of the PCL tibial attachment,a portion of which is located outside the articular cavity,when the PCL tibial avulsion fractures,the fracture end is frequently embedded in the articular capsule and surrounding soft tissue,making manipulation difficult.Surgical treatment is currently the most commonly used treatment method for displaced PCL tibial avulsion fracture by domestic and foreign scholars,with open reduction being the most commonly used surgical method,and different fixation methods are selected based on the size and degree of fracture.Due to the anatomical characteristics of the PCL tibial attachment,a portion of which is located outside the articular cavity,when the PCL tibial avulsion fractures,the fracture end is frequently embedded in the articular capsule and surrounding soft tissue,making manipulation difficult.At the moment,surgical treatment is the most commonly used treatment method for displaced PCL tibial avulsion fracture by domestic and foreign scholars,with open reduction being the most commonly used surgical method,and different fixation methods are chosen based on the size and degree of fracture.On the basis of these two types of operation methods,we improved,through popliteal fossa horizontal grain inside small incision into the muscle,tendon and tendon,muscle and gastrocnemius anatomical gap,the medial head of the gastrocnemius muscle with thyroid hook neurovascular pull outward along with the popliteal fossa,half film muscle and tendon muscle to pull,intraoperative not to free of neurovascular,articular and fractures can reveal,It has the advantages.Objective: To compare the clinical efficacy of the posterior medial knee minimally invasive approach and the traditional inverted "L" approach in the treatment of PCL tibial avulsion fracture,and to assess the clinical application value of the posterior knee minimally invasive approach in the treatment of PCL tibial avulsion fracture.Methods: Clinical data of PCL tibial avulsion fracture patients treated in our hospital f KROM January 2016 to January 2020 were retrospectively gathered,screened,compared,and analyzed.Gender,age,injury lateral location,BMI,injury etiology,Meyers Mc Keever grading,time KROM injury to surgery,International Knee Documentation Committee（IKDC）score,and Lysholm score before surgery were not significantly different between the two groups（P > 0.05）.The two groups were compared on incision length,operative time,intraoperative blood loss,postoperative VAS pain score,fracture healing time,and other factors.The two groups were compared in terms of KROM,IKDC,and Lysholm scores before and after surgery,and residual relaxation of the affected limbs was assessed using the KT-2000.Results: The surgical procedures were smooth in both groups,and the surgical incision length and intraoperative blood loss in the minimally invasive posterior knee approach group were smaller than those in the traditional inverted "L" approach group,with statistically significant differences（P < 0.05）.There were no significant differences in operation time and fracture healing time between 2 groups（P > 0.05）.Postoperative Lachman test and back drawer test were both negative,and postoperative incision healing was stage I without related complications.VAS pain score within 2 weeks and KROM within 4 weeks in the minimally invasive group were better than those in the traditional inverted "L" approach group,with statistical significance（P < 0.05）.Twelve months after surgery,the knee joint stability of 2 groups was good,and there was no statistical significance in IKDC,Lysholm score,KROM and residual relaxation（P >0.05）.Conclusion: The minimally invasive posterior knee approach for the treatment of PCL tibial avulsion fracture has the advantages of less surgical trauma,clear exposure,simple operation,light postoperative pain,and does not require a long learning curve. |
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