Arthroscopy-assisted Reduction And Internal Fixation The Treatment Of Anterior Cruciate Ligament Tibial Eminence Avulsion Fracture With Cannulated Screw

ObjectiveTo summarize the curative effect of only arthroscopy-assisted reduction and internal fixation in the treatment of anterior cruciate ligament tibial eminence avulsion fractures with AO cannulated screw and postoperative integrated tcm-wm rehabilitation.MethodsFrom May2010to December2011, according to the diagnostic criteria of cases, included standards and exclusion criteria,27patients with anterior cruciate ligament tibial eminence avulsion fractures were selected, all single knee. These fractures were reduced and internal fixed arthroscopy-assisted with one or two AO annulated screws. And these patients were treated with postoperative rehabilitation early and then with traditional Chinese medicines. After the collection of both pre-and-postoperative signs and symptoms, the follow-up X-Rays, retrospective analysis was applied. Based on the comparison of the changes, knee joint function was evaluated by Lysholm and IKDC score.Result All27patients were followed up over6months, to recheck X-Ray in postoperative period relatively on the first day, the day of knee joint ROM:90°-0°-0°, postoperative second month and postoperative sixty month. According to the X-ray, the fractures were healed well and these were no displacement. The patients all walked normally. Affected extremity could bear full weight and knee joint ROM was proved to110°-0°-0°. Physical examination:ADT、 Lachman test and pivot shift test all were negative. There were no pains, no swelling or distension obviously and no complications of joint laxity and instability. There were no inter-condylar fossa impingement, corpus liberum in knee joint, traumatic arthritis and DVT. The Lysholm scores were proved from preoperative50.81±9.798to postoperative94.04±4.711(P<0.01). There had been statistical significance. The IKDC scores were significant anomalism (D-level)19cases and abnormal (C-level)8cases, having been improved to (A-level)22cases and nearly normal (B-level)5cases (P<0.01). There had been statistical significance.ConclusionArthroscopy-assisted reduction and internal fixation with AO cannulated screw and postoperative integrated tcm-wm rehabilitation early is proved effective for anterior cruciate ligament tibial spine avulsion fractures. Arthroscopic treatment has only micro-trauma、needs only short time of therapy and has less influence on knee joint. This is a feasible method to treat tibial spine avulsion fracture of anterior cruciate ligament and thus is worth extending clinically.