title: [Absorbable screw fixation for the treatment of tibial avulsion fracture of the tibial attachment of the posterior cruciate ligament through posterior middle mini incision of knee joint].
abstract: OBJECTIVE
  To investigate method of absorbable screw fixation for the treatment of tibial avulsion fracture of the tibial attachment of the posterior cruciate ligament through posterior middle mini incision of knee joint, and evaluate its clinical results.
  
  
  METHODS
  From January 2007 to December 2011,50 patients with tibial avulsion fracture of the tibial attachment of the posterior cruciate ligament were treated with absorbable screw fixation through posterior middle mini incision. Among the patients, 38 patients were male and 12 patients were female,ranging in age from 18 to 62 years old,with an average of 36.8 years old. The duration of the disease ranged from 1 to 52 weeks. During the opeation, the blood vessels and nerves should be protected. Clinical results were evaluated according to the physical examination, Lysholm and IKDC clinical rating scales.
  
  
  RESULTS
  There were no nails broken in surgery, no postoperative complications such as infection, sinus formation and fracture fragment displacement. One patient had delay healing of incision. All the patients were followed up, and the duration ranged from 6 to 42 months,with an average of 30 months. All the patients got bony union at the latest follow-up. Two patients had functional limitation of knee joint due to delayed review. At the latest follow-up, Lachman test and posterior drawer test were either negative or limited in grade I of laxity. The range of motion of 50 patients improved from preoperative (94.5 +/- 6.2)degrees (90 degrees to 110 degrees) to postoperative (135.5 +/- 4.0) degrees (130 degrees to 140 degrees). Lysholm score of all patients improved from preoperative 37.0 +/- 10.0(25 to 56) to 87.0 +/- 4.8 (81 to 98) at the latest follow-up. Additionally,IKDC scores increased from preoperative 40.3 +/- 9.6 (27 to 61) to 85.1 +/- 2.6 (82 to 96) at the latest follow-up. There were statistical differences in the Lysholm and IKDC scores comparing preoperative data with that at the latest follow-up. Based on Lysholm score,42 patients got an excellent result, 5 good and 3 poor; according to IKDC score,41 patients got A degree and 9 patients got B degree.
  
  
  CONCLUSIONS
  Absorbable screw fixation is a safe and effective method for the treatment of tibial avulsion fracture of the tibial attachment of the posterior cruciate ligament. A middle posterior approach with a mini incision can short operative time and reduce the chance of injuries of blood vessels and nerves. Absorbable screw fixation has a satisfactory clinical efficacy with strictly control of surgical indications.
authors.affiliation: Department of Orthopaedics, West China Hospital Affiliated to Sichuan University, Chengdu, Sichuan, China.
authors.forename: Zhi-Song
authors.initials: ZS
authors.lastname: Ouyang
authors.affiliation: Department of Orthopaedics, West China Hospital Affiliated to Sichuan University, Chengdu, Sichuan, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Orthopaedics, West China Hospital Affiliated to Sichuan University, Chengdu, Sichuan, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016119:Posterior Cruciate Ligament / Q000293:injuries* / Q000601:surgery; D013978:Tibial Fractures / Q000601:surgery*