Arthroscopic treatment of avulsion fracture of tibial attachment of anterior cruciate ligament using double Endobutton plates

Abstract

Objective To explore the feasibility and curative effect of arthroscopic treatment of avulsion fracture of the tibial attachment of anterior cruciate ligament (ACL) using Ethibood line plus double Endobutton plates. Methods From May 2014 to January 2016, 26 cases of acute ACL tibial attachment fracture were treated surgically. They were 16 males and 10 females, aged from 9 to 45 years (average, 26.6 years). By the Meyers-McKeeve classification, there were 17 cases of type Ⅱ and 9 ones of type Ⅲ. In preoperative examina-tion, their Lachman test and Anterior Drawer Test were all positive. All their bone blocks were fixated using Ethibond line plus double Endobutton plates. Results Their operative time ranged from 50 to 70 min, averaging 57 min. On average, the 26 patients obtained a follow-up of 8 months (from 6 to 13 months). X-rays at 3 months after operation showed all fractures united. At the last follow-up, their Lachman test and Anterior Drawer Test were all negative. The range of motion of the knee joint was larger than 120° in all; their Lysholm score of the knee joint averaged 90.6±2.9 points, significantly higher than their preoperative value (43.6±4.7 points) (t=7.583, P=0.026); their International Knee Documentation Committee (IKDC) scores averaged 93.1±4.2 points, significantly higher than their preoperative value (46.3±5.1 points) (t=8.162, P=0.021). No such complications as reflexive neural dystrophy, avascular necrosis or weak knee extension occurred during follow-ups. Conclusion The avulsion fractures of ACL tibial attachment can be treated arthroscop-ically using Ethibood line plus double Endobutton plates, because this technique has such advantages as simple operation, limited invasion, good fracture reduction, strong fixation, and possibility of early functional rehabil-itation of the knee joint. Key words: Arthroscopy; Anterior cruciate ligament; Tibial fractures; Fracture fixation, inter-nal; Bone plates