[Arthroscopic treatment of tibial intercondylar ridge avulsion fracture with double-root line double tunnel fixation technique].

OBJECTIVE: To discuss arthroscopic technique of double-root line double tunnel fixation for tibial intercondylar ridge avulsion fracture and its short-term followvup observational results. METHODS: From May 2012 to June 2017, 21 cases of tibial intercondylar ridge avulsion fractures were treated with arthroscope double line double tunnel. Among the patients, 16 males and 5 females were ranging in age from 17 to 45 years old, with an average of 29.6 years old, and injury to surgery time 3 to 6 days, with an average of 3.6 days. All the patients underwent arthroscopic exploration, fracture reduction, double root line fixation. The knee function was assessed at 3 and 6 months postoperatively using the Lysholm knee score, and the healing and resection of the patients were followed by X-ray examination. RESULTS: All patients were followed up for 7 to 23 months, with an average of 12.8 months. All patients after fracture were bone healing, knee activity were gained their previous normal levels (ranged, 0° to 130 °), and no limb dysfunction. The average scores of Lysholm knee were(93.52±7.10) and(95.95±6.34) points in 3 months and 6 months after operation. CONCLUSIONS: Arthroscopic treatment of tibial intercondylar ridge avulsion fractures with double root line is simple and reliable, and can provide an ideal internal fixation method for tibial intercondylar ridge avulsion fractures.

[Treatment of posterolateral tibial plateau fractures through an extended anterolateral approach].

OBJECTIVE: To study the methods and therapeutic effects of posterolateral tibial plateau fractures with an extended anterolateral approach. METHODS: From January 2011 to December 2013, 15 patients with posterolateral tibial plateau fractures were treated by extended anterolateral approach, including 9 males and 6 females, with an average age of (38.4±7.7) years old ranging from 23 to 70 years old. Seven patients were on the left knees and 8 patients were on the right knees. The injury causes included traffic accidents in 6 cases, falling from height in 7 cases, and falling down when walking in 2 cases. The time from injury to operation was 2 to 14 days (means 5.6 days). RESULTS: All patients were followed up with an average of 19.7 months ranging from 12 to 30 months. All patients were followed with anteroposterior and lateral X ray and CT films, which showed anatomic reduction or near anatomic reduction. The follow up CT scan showed an anatomic reduction in 14 patients and step and gap measurement of 3 mm in 1 case. The average radiographic bony union time was 9.6 weeks (ranged from 8 to 14 weeks). There were no wound complications, nonunion, plate loosening or breakage, valgus knee deformity, or fracture redisplacement. No patients sustained neural or vascular injuries, with knee extension of (2.1±2.1)° and knee flexion of (120.6±18.9)° at the final follow up. The total Rasmussen score averaged (25.0±2.8) points, the result was excellent in 10 cases, good in 4 cases, fair in 1 case. CONCLUSIONS: The extended anterolateral approach has the advantage of allowing visualization of the posterolateral tibial plateau fragments, therefore facilitating its reduction. The approach also ensures safe and adequate posterior placement of a lateral buttress plate because the plate can be placed more posteriorly than can occur through an anterolateral approach.