Arthroscopic fixation with screws versus sutures for anterior cruciate ligament tibial avulsion fractures

Abstract

Objective To compare the curative effects between arthroscopic screw and suture fixations for anterior cruciate ligament (ACL) tibial avulsion fractures. Methods From November 2007 to November 2012, 41 patients with ACL tibial avulsion fracture underwent arthroscopy at our department. They were 32 males and 9 females, 8 to 43 years of age (average, 18.3 years). By the Meyers-McKeever-Zaricznyj classification, 12 cases were type Ⅱ and 29 type Ⅲ. There were 19 cases in the screw fixation group, including 14 males and 5 females, 9 to 42 years of age (average, 18.9 years). The suture fixation group had 22 cases, including 16 males and 6 females, 8 to 43 years of age (average, 17.8 years). Operation time, knee range of motion (ROM), case of flexion contracture, Lysholm score, international knee documentation committee (IKDC) score, and side-to-side mobile difference by KT-2000 were evaluated. The 2 groups were similar in age, gender, fracture type and time from injury to surgery (P > 0.05). Results The operation time for the suture fixation group (58.9±6.7 min) was significantly longer than that for the screw fixation group (51.6±6.2 min) (P 0.05). Conclusions In treatment of ACL tibial avulsion fractures of types Ⅱ and Ⅲ, there is no significant difference between arthroscopic screw fixation and suture fixation, because both methods can achieve good stability and functional recovery. Intraoperative fluoroscopy should be used to ensure anatomical reduction and early functional rehabilitation should be encouraged postoperatively to reduce such complications as joint instability and limited motion. Key words: Arthroscopy; Sutures; Fracture fixation, internal; Anterior cruciate ligament