Post on 19-Jan-2016
Arthroscopically Assisted Treatment of Avulsion Fractures of the Posterior Cruciate Ligament from the Tibia
by Sung-Jae Kim, Sang-Jin Shin, Nam-Hong Choi, and Shin-Kang Cho
J Bone Joint Surg AmVolume 83(5):698-708
May 1, 2001
©2001 by The Journal of Bone and Joint Surgery, Inc.
Posterior view of a right knee.
Sung-Jae Kim et al. J Bone Joint Surg Am 2001;83:698-708
©2001 by The Journal of Bone and Joint Surgery, Inc.
Axial view (Fig. 2-A) and sagittal section(Fig. 2-B) of the perforation made through the posterior septum behind the posterior cruciate ligament.
Sung-Jae Kim et al. J Bone Joint Surg Am 2001;83:698-708
©2001 by The Journal of Bone and Joint Surgery, Inc.
Axial view (Fig. 2-A) and sagittal section(Fig. 2-B) of the perforation made through the posterior septum behind the posterior cruciate ligament.
Sung-Jae Kim et al. J Bone Joint Surg Am 2001;83:698-708
©2001 by The Journal of Bone and Joint Surgery, Inc.
Viewed through the posteromedial portal, avulsion of the tibial attachment of the posterior cruciate ligament (PCL) can be seen (arrows).
Sung-Jae Kim et al. J Bone Joint Surg Am 2001;83:698-708
©2001 by The Journal of Bone and Joint Surgery, Inc.
A tibial posterior cruciate ligament guide (A) placed through the anteromedial portal is used to secure the fracture fragment (C) and to guide insertion of a threaded Kirschner wire (arrow).
Sung-Jae Kim et al. J Bone Joint Surg Am 2001;83:698-708
©2001 by The Journal of Bone and Joint Surgery, Inc.
A long 18‐gauge spinal needle is inserted through the posterolateral sheath and passed through the posterior cruciate ligament just proximal to the fracture fragment, and a 23‐gauge wire is
passed through the lumen of the needle.
Sung-Jae Kim et al. J Bone Joint Surg Am 2001;83:698-708
©2001 by The Journal of Bone and Joint Surgery, Inc.
The 23‐gauge wire or multiple sutures are pulled out through a sheath placed in the anteromedial portal, and the needle is removed.
Sung-Jae Kim et al. J Bone Joint Surg Am 2001;83:698-708
©2001 by The Journal of Bone and Joint Surgery, Inc.
Two bone tunnels are made from the anterior tibial cortex to the medial and lateral margins of the fracture bed.
Sung-Jae Kim et al. J Bone Joint Surg Am 2001;83:698-708
©2001 by The Journal of Bone and Joint Surgery, Inc.
Two looped wires are pulled distally, leading each end of the 23‐gauge wire or the multiple sutures through the medial and lateral bone tunnels.
Sung-Jae Kim et al. J Bone Joint Surg Am 2001;83:698-708
©2001 by The Journal of Bone and Joint Surgery, Inc.
Each end of the previously passed 23‐gauge wire or multiple sutures is pulled distally with even tension until the fracture fragment is accurately reduced.
Sung-Jae Kim et al. J Bone Joint Surg Am 2001;83:698-708
©2001 by The Journal of Bone and Joint Surgery, Inc.
Case 8.
Sung-Jae Kim et al. J Bone Joint Surg Am 2001;83:698-708
©2001 by The Journal of Bone and Joint Surgery, Inc.
Case 8.
Sung-Jae Kim et al. J Bone Joint Surg Am 2001;83:698-708
©2001 by The Journal of Bone and Joint Surgery, Inc.
Case 10.
Sung-Jae Kim et al. J Bone Joint Surg Am 2001;83:698-708
©2001 by The Journal of Bone and Joint Surgery, Inc.
Case 10.
Sung-Jae Kim et al. J Bone Joint Surg Am 2001;83:698-708
©2001 by The Journal of Bone and Joint Surgery, Inc.
Case 13.
Sung-Jae Kim et al. J Bone Joint Surg Am 2001;83:698-708
©2001 by The Journal of Bone and Joint Surgery, Inc.
Case 13.
Sung-Jae Kim et al. J Bone Joint Surg Am 2001;83:698-708
©2001 by The Journal of Bone and Joint Surgery, Inc.