Andrew D Wohler1, David P Trofa2, Joshua D Meade3,4, Ian S Hong3,4, Claude T Moorman3,4, Dana P Piasecki3,4, Bryan M Saltzman5,6, James E Fleischli3,4. 1. Department of Orthopaedic Surgery, Atrium Health, Charlotte, NC, USA. 2. Columbia University Medical Center, New York, NY, 10032, USA. 3. OrthoCarolina Sports Medicine Center, 1915 Randolph Rd, Charlotte, NC, 282077, USA. 4. Atrium Health-Musculoskeletal Institute, 1320 Scott Ave, Charlotte, NC, 28203, USA. 5. OrthoCarolina Sports Medicine Center, 1915 Randolph Rd, Charlotte, NC, 282077, USA. Bryan.Saltzman@orthocarolina.com. 6. Atrium Health-Musculoskeletal Institute, 1320 Scott Ave, Charlotte, NC, 28203, USA. Bryan.Saltzman@orthocarolina.com.
Abstract
INTRODUCTION: A novel technique using an adjustable-loop cortical suspension toggle device for reduction of a fibular head avulsion fracture (arcuate fracture) in posterolateral corner (PLC) reconstruction is described. Results of clinical follow-up are presented. MATERIALS AND METHODS: 9 patients were retrospectively identified who underwent posterolateral corner reconstruction using an adjustable-loop cortical suspension toggle device. Radiographic examination was used to evaluate the successful healing of the avulsed fibular head fragments post-operatively. RESULTS: 7 patients reported satisfactory results with their clinical outcome with no feelings of knee instability or objective instability on exam at final follow-up. Post-operative radiographs obtained > 6 months following reconstruction demonstrated well reduced and healed fracture in 5 of 6 patients, with 1 patient demonstrating maintained reduction but incomplete fracture union at 6 months. CONCLUSION: This novel surgical technique for PLC reconstruction with an avulsed fibular head fracture is a viable alternative to previously described methods. The majority of patients report subjective satisfaction with a stable knee post-operatively. LEVEL OF EVIDENCE: IV.
INTRODUCTION: A novel technique using an adjustable-loop cortical suspension toggle device for reduction of a fibular head avulsion fracture (arcuate fracture) in posterolateral corner (PLC) reconstruction is described. Results of clinical follow-up are presented. MATERIALS AND METHODS: 9 patients were retrospectively identified who underwent posterolateral corner reconstruction using an adjustable-loop cortical suspension toggle device. Radiographic examination was used to evaluate the successful healing of the avulsed fibular head fragments post-operatively. RESULTS: 7 patients reported satisfactory results with their clinical outcome with no feelings of knee instability or objective instability on exam at final follow-up. Post-operative radiographs obtained > 6 months following reconstruction demonstrated well reduced and healed fracture in 5 of 6 patients, with 1 patient demonstrating maintained reduction but incomplete fracture union at 6 months. CONCLUSION: This novel surgical technique for PLC reconstruction with an avulsed fibular head fracture is a viable alternative to previously described methods. The majority of patients report subjective satisfaction with a stable knee post-operatively. LEVEL OF EVIDENCE: IV.