Oleg Yastrebov1, Philipp Lobenhoffer. 1. Klinik für Unfall- und Wiederherstellungschirurgie, Henriettenstiftung, Hannover. oleg.yastrebov@ddh-gruppe.de
Abstract
OBJECTIVE: Posteromedial approach to the knee. Exact reduction and fixation of avulsed tibial attachment of posterior cruciate ligament with small-fragment plate. INDICATIONS: Avulsed tibial attachment of posterior cruciate ligament. CONTRAINDICATIONS: Ligamentous rupture of the posterior cruciate ligament. Local soft-tissue problems. SURGICAL TECHNIQUE: Posteromedial approach with mobilization and retraction of the medial gastrocnemius muscle. Subperiosteal detachment of the popliteal muscle. Identification of fracture site. Longitudinal incision of the posterior capsule of the knee. Debridement of the fracture site, reposition and stabilization with small-fragment plate. POSTOPERATIVE MANAGEMENT: Partial weight bearing with 15 kg for 6 weeks, limitation of knee flexion to 90° for 6 weeks. A special joint orthesis is not necessary. The use of an EMT unit is recommended to prevent muscular atrophy. RESULTS: Six patients (four female, two male) with avulsed tibial attachment of posterior cruciate ligament were treated using the posteromedial approach.
OBJECTIVE: Posteromedial approach to the knee. Exact reduction and fixation of avulsed tibial attachment of posterior cruciate ligament with small-fragment plate. INDICATIONS: Avulsed tibial attachment of posterior cruciate ligament. CONTRAINDICATIONS: Ligamentous rupture of the posterior cruciate ligament. Local soft-tissue problems. SURGICAL TECHNIQUE: Posteromedial approach with mobilization and retraction of the medial gastrocnemius muscle. Subperiosteal detachment of the popliteal muscle. Identification of fracture site. Longitudinal incision of the posterior capsule of the knee. Debridement of the fracture site, reposition and stabilization with small-fragment plate. POSTOPERATIVE MANAGEMENT: Partial weight bearing with 15 kg for 6 weeks, limitation of knee flexion to 90° for 6 weeks. A special joint orthesis is not necessary. The use of an EMT unit is recommended to prevent muscular atrophy. RESULTS: Six patients (four female, two male) with avulsed tibial attachment of posterior cruciate ligament were treated using the posteromedial approach.