Summary

Arthroscopic double Endobutton plate in the treatment of PCL tibial avulsion fracture was with minimally invasive, imitation of biomechanics, reliable fixation and the size of bone block did not affect the operation plan. Operation was simple, Recovery was quick.

Abstract

Prupose: To investigate the effect of arthroscopic double Endobutton plate in the treatment of posterior cruciate ligament （PCL）tibial avulsion fracture.
Methods:15 cases of tibial avulsion fracture of PCL treated by arthroscopy from May 2014 to April 2016 were selected. After arthroscopic fracture debridement, reduction, the piercing positioning accurately bed beneath positioning in the tibial fracture by using PCL tibial guide device through the tunnel between cruciate ligament and the lateral wall of the medial condyle into posterior articular cavity. From the 2cm medial of tibial tubercle to positioning point 4.5mm bone tunnel were drilled. Pilot wire threaded via posterior cruciate ligament tendon near tibial from the front to the back, then went through the bone tunnel from the back to the front. Single loop length 5.0cm Endobutton loop with double high strength wire, high strength wire were leaded by the pilot wire from the intercondylar to bone tunnel. Repeated tightening high strength wire, So Endobutton plate compacted the bone block and fracture reduction. The end of high-strength wire were tightening with Endobutton in the medial plane of the tibial tubercle. Comparison of preoperative and postoperative Lysholm score and knee joint motion.
Results:15 cases were followed up for 3~18 months with an average of 9.6 months. At the time of the last follow-up when X-ray film showed that the fracture was anatomically reduced or near anatomic reduction. 2 patients withⅠdegree of positive posterior drawer test，others drawer test were negative. Postoperative Lysholm score (94.2±3.6), and preoperative (46.1± 2.7), the difference is statistically significant (P < 0.05). There were 13 patients with normal knee motion after operation, 2 patients with mild limited knee flexion 4~8 weeks after operation, knee flexion 0 ~90 degree, and the motion of the knee joint recovered to 0 degree ~120 degree after manipulation release.
Conclusion:Arthroscopic double Endobutton plate in the treatment of PCL tibial avulsion fracture was with minimally invasive, imitation of biomechanics, reliable fixation and the size of bone block did not affect the operation plan. Operation was simple, Recovery was quick, it was worth popularization and application.