[Application of portable bracket of lower limb in reconstruction of anterior cruciate ligament by long fibular muscle tendon under arthroscopy].
OBJECTIVE
To investigate the effectiveness of portable bracket of lower limb in the reconstruction of anterior cruciate ligament (ACL) by the long fibular muscle tendon under arthroscopy.


METHODS
Between March 2008 and September 2010, 22 patients with ACL injury were treated. The limb position was maintained by portable bracket of lower limb and ACL was reconstructed with the long fibular muscle tendon under arthroscopy. There were 15 males and 7 females with an average age of 33.8 years (range, 19-64 years). The causes of ACL injury were traffic accident injury in 14 cases, sport trauma in 5 cases, and falling injury in 3 cases. The locations were the left knee in 10 cases and the right knee in 12 cases, including 12 fresh injuries and 10 old injuries. Of 22 patients, 17 had positive anterior drawer test, 19 had positive pivot shift test, and 20 had positive Lachman test. According to International Knee Documentation Committee (IKDC) criteria, there were 6 abnormal and 16 severely abnormal. The subjective IKDC score was 57.64 +/- 6.11. The Lysholm score was 55.45 +/- 4.37.


RESULTS
All incisions healed by first intention, and no complication was found. All patients were followed up 9-38 months (mean, 15 months). At last follow-up, the flexion of the knee ranged from 120 to 135 degrees (mean, 127 degrees). One patient had positive anterior drawer test, 1 patient had positive pivot shift test, and 2 patients had positive Lachman test. No ligament loosening and breakage occurred. According to the IKDC criteria, 10 patients rated as normal, 11 patients as nearly normal, and 1 patient as abnormal. The subjective IKDC score was 90.44 +/- 6.11, showing significant difference when compared with preoperative one (t=4.653, P=0.021). The Lysholm score was 90.12 +/- 5.78, showing significant difference when compared with preoperative one (t=4.231, P=0.028).


CONCLUSIONS
Portable bracket of lower limb in the reconstruction of ACL has the advantages of saving manpower and easy operation. The long fibular muscle tendon is enough long and strong to reconstruct the ACL, which can increase the contact surface between the tendon and bone and is beneficial to tendon-bone healing.
Traumatic Orthopedic Center of Chinese PLA, 175th Hospital of Chinese PLA, Dongnan Hospital Affiliated to Xiamen University, Zhangzhou Fujian, 363000, P.R.China. gzmin175@163.com
Zhimin
Z
Guo
Jiapeng
J
Zheng
Bin
B
Lin
Zhenqi
Z
Ding
Zhiwen
Z
Chen
D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000295:instrumentation / Q000379:methods*; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D005360:Fibula; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D013536:Suture Techniques; D013710:Tendons / Q000637:transplantation*; D016896:Treatment Outcome; D055815:Young Adult