title: Treatment of posterior cruciate ligament avulsion fractures of the tibia using a toothed plate and hollow lag screw.
abstract: BACKGROUND
  To investigate the feasibility and clinical efficacy of using a toothed plate and hollow lag screw in the surgical treatment of posterior cruciate ligament (PCL) avulsion fractures of the tibia.
  
  
  METHODS
  A total of 21 patients were treated with open reduction and internal fixation using a toothed plate and hollow lag screw, through a posteromedial approach using an inverted L-shaped incision. The patients were allowed appropriate functional exercises, including knee flexion and extension, after removal of the plaster at postoperative weeks 3-6. The follow-up period was between six months and two years.
  
  
  RESULTS
  This was a retrospective study of patients with PCL avulsion fractures of the tibia caused by road traffic accidents (n = 9), sports-related injuries (n = 6), falls (n = 5) and machinery-related injuries (n = 1). 20 patients presented with fresh fractures and one with an old fracture. The patients (13 men, eight women) had a mean age of 41.5 (range 19-72) years. Anatomical reduction of the fracture and satisfactory fixation were achieved in all 21 patients. Bony union was achieved in all patients at 8-12 weeks after surgery. Six months after surgery, knee flexion was 121.9° ± 10.4° and extension was 0°. According to the Lysholm Knee Scoring Scale, 19 patients were rated as 'excellent' and two as 'good'.
  
  
  CONCLUSIONS
  The use of a toothed plate and hollow lag screw could be a simple and reliable approach for PCL avulsion fractures of the tibia. Patients achieved good knee function after surgery.
authors.affiliation: Department of Orthopaedics, Tianjin Third Central Hospital, Tianjin, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Orthopaedics, Tianjin Third Central Hospital, Tianjin, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Luo
authors.affiliation: Department of Orthopaedics, Tianjin Third Central Hospital, Tianjin, China.
authors.forename: Zhiqing
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Orthopaedics, Tianjin Third Central Hospital, Tianjin, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Jiang
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D000071562:Fractures, Avulsion / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016119:Posterior Cruciate Ligament / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000175:diagnosis / Q000601:surgery*; D055815:Young Adult
keywords: fracture; internal fixation; posterior cruciate ligament; toothed plate
references.citation: Arthroscopy. 2007 Nov;23(11):1226-30
references.pmid: 17986411
references.citation: Radiographics. 1995 May;15(3):551-61
references.pmid: 7624562
references.citation: Arch Orthop Trauma Surg. 2012 Apr;132(4):429-35
references.pmid: 22080931
references.citation: Am J Sports Med. 1982 May-Jun;10(3):150-4
references.pmid: 6896798
references.citation: Zhonghua Wai Ke Za Zhi. 2005 Dec 15;43(24):1598-601
references.pmid: 16412310
references.citation: J Bone Joint Surg Am. 2007 Jul;89(7):1598-604
references.pmid: 17606801
references.citation: J Bone Joint Surg Am. 2009 Apr;91(4):859-66
references.pmid: 19339570
references.citation: Knee Surg Sports Traumatol Arthrosc. 2006 Apr;14(4):340-2
references.pmid: 16328460
references.citation: Sports Med. 1999 Dec;28(6):429-41
references.pmid: 10623985
references.citation: Arthroscopy. 2003 Mar;19(3):262-8
references.pmid: 12627150
references.citation: Arthroscopy. 2003 Oct;19(8):916-21
references.pmid: 14551559
references.citation: J Orthop Trauma. 2000 Aug;14(6):420-5
references.pmid: 11001416
references.citation: Arch Orthop Trauma Surg. 2003 May;123(4):186-91
references.pmid: 12734718
references.citation: Curr Opin Rheumatol. 2002 Mar;14(2):142-9
references.pmid: 11845019
references.citation: Knee Surg Sports Traumatol Arthrosc. 2010 Jun;18(6):781-3
references.pmid: 19826788
references.citation: J Orthop Surg Res. 2010 Sep 08;5:67
references.pmid: 20825638