Clinical efficacy of arthroscopic treatment with anchor fixation for Segond fractures

Abstract

Objective To evaluate the clinical efficacy of arthroscopic treatment with anchor fixation for Segond fractures. Methods A total of 29 patients with Segond fractures treated with arthroscopic evaluation and anchor fixation technique between January 2011 and December 2015 were included in this retrospective case series study. There were 17 males and 12 females, with an average age of 41 years (range, 27-62 years). Among the patients with Segond fractures, there were 20 patients combined with anterior cruciate ligament (ACL) rupture, three with posterior cruciate ligament (PCL) rupture, seven with medial collateral ligament (MCL) lesion, six with lateral collateral ligament (LCL) rupture, 12 with meniscus lesion, and two with tibial plateau fracture. The time duration from injury to operation was 5-14 days (mean, 7 days). The operation time and intraoperative blood loss volume were recorded. The postoperative pain, complications, knee joint stability, and fracture healing were observed. The pain was evaluated using numerical rating scale (NRS). Drawer test, Lachman test, lateral stress test, and Lysholm scores were performed to assess the knee function before and after operation. Results The operation time was 40-125 minutes (mean, 85 minutes), and intraoperative blood loss was 10-30 ml (mean, 15 ml). All patients were followed up for 12-18 months (mean, 14 months). Two weeks after operation, the pain was not obvious, with NRS of 0-1. One patient had deep venous thrombosis one week after operation, and recovered after vascular intervention therapy. Other patients had no infection, deep vein thrombosis or other postoperative complications. The results of drawer test, Lachman test, and lateral stress test were negative in all patients, which indicated good knee joint stability. All patients were seen bone union, with the healing rate of 100%. The preoperative Lysholm scores were 35-62 points [(52.0±4.2) points] , and the scores one year after operation were 86-95 points [(91.9±1.4) points] (P<0.05). Conclusion Arthroscopic treatment with anchor fixation has advantages of minor trauma, little hemorrhage, high fracture healing rate and good function recovery, and hence is an effective surgical treatment for Segond fractures. Key words: Tibial fractures; Anterior cruciate ligament; Posterior cruciate ligament; Meniscus