Versorgung knöcherner hinterer kreuzbandausrisse über einen minimal-invasiven dorsalen zugang
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Versorgung knöcherner hinterer kreuzbandausrisse über einen minimal-invasiven dorsalen zugang. / Frosch, K -H; Proksch, N; Preiss, A; Giannakos, A.
In: OPER ORTHOP TRAUMATO, Vol. 24, No. 4-5, 09.2012, p. 348-53.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Versorgung knöcherner hinterer kreuzbandausrisse über einen minimal-invasiven dorsalen zugang
AU - Frosch, K -H
AU - Proksch, N
AU - Preiss, A
AU - Giannakos, A
PY - 2012/9
Y1 - 2012/9
N2 - OBJECTIVE: Reduction and fixation of bony avulsions of the posterior cruciate ligament (PCL) through a minimally invasive dorsal approach to restore stability of the knee joint. Prevention of soft tissue damage through a minimally invasive procedure and achieving early functional rehabilitation by stable osteosynthesis.INDICATIONS: Bony tibial avulsions of the PCL and simple posteromedial tibial fractures.CONTRAINDICATIONS: Infections in or around the knee, critical soft tissue conditions and lack of patient compliance. OPERATION TECHNIQUE: Supine position, skin incision mediodorsal over the head of the medial gastrocnemius muscle. After dissection of soft tissue and superficial fascia the medial gasteocnemius muscle is retracted to the lateral side, nerves and vessels of the popliteal fossa are thereby protected. Incision of the posterior capsule from the tibial attachment, exposure of the fracture and the PCL, reduction of the fracture, fixation with two drill wires and definitive fixation with two cannulated screws. In case of multifragment fracture a suture anchor is used for fixation.POSTOPERATIVE MANAGEMENT: Partial weight bearing of 10-20 kg for 4-6 weeks and limitation of knee flexion up to 90° for 4 weeks.RESULTS: Between November 2010 and November 2011 three patients were treated with the new minimally invasive posteromedial approach to fix bony avulsions of the PCL. In two cases an osteosynthesis with two screws was performed and in the other patient a comminuted avulsion fracture was fixed with a suture anchor. In the latter patient the posterolateral corner was additionally augmented according to Larson with an autologous semitendinosus tendon. No intraoperative or postoperative complications could be observed. In all three patients an excellent fracture reduction without steps or gaps could be achieved. In two cases an early functional treatment protocol and in one case (suture anchor fixation plus augmentation of the posterolateral corner) a special postoperative PCL rehabilitation protocol was used. Good clinical results with stable knee joints could be achieved in all cases. The minimally invasive dorsal approach for the treatment of bony avulsions of the PCL was demonstrated to be safe and simple with a low complication rate.
AB - OBJECTIVE: Reduction and fixation of bony avulsions of the posterior cruciate ligament (PCL) through a minimally invasive dorsal approach to restore stability of the knee joint. Prevention of soft tissue damage through a minimally invasive procedure and achieving early functional rehabilitation by stable osteosynthesis.INDICATIONS: Bony tibial avulsions of the PCL and simple posteromedial tibial fractures.CONTRAINDICATIONS: Infections in or around the knee, critical soft tissue conditions and lack of patient compliance. OPERATION TECHNIQUE: Supine position, skin incision mediodorsal over the head of the medial gastrocnemius muscle. After dissection of soft tissue and superficial fascia the medial gasteocnemius muscle is retracted to the lateral side, nerves and vessels of the popliteal fossa are thereby protected. Incision of the posterior capsule from the tibial attachment, exposure of the fracture and the PCL, reduction of the fracture, fixation with two drill wires and definitive fixation with two cannulated screws. In case of multifragment fracture a suture anchor is used for fixation.POSTOPERATIVE MANAGEMENT: Partial weight bearing of 10-20 kg for 4-6 weeks and limitation of knee flexion up to 90° for 4 weeks.RESULTS: Between November 2010 and November 2011 three patients were treated with the new minimally invasive posteromedial approach to fix bony avulsions of the PCL. In two cases an osteosynthesis with two screws was performed and in the other patient a comminuted avulsion fracture was fixed with a suture anchor. In the latter patient the posterolateral corner was additionally augmented according to Larson with an autologous semitendinosus tendon. No intraoperative or postoperative complications could be observed. In all three patients an excellent fracture reduction without steps or gaps could be achieved. In two cases an early functional treatment protocol and in one case (suture anchor fixation plus augmentation of the posterolateral corner) a special postoperative PCL rehabilitation protocol was used. Good clinical results with stable knee joints could be achieved in all cases. The minimally invasive dorsal approach for the treatment of bony avulsions of the PCL was demonstrated to be safe and simple with a low complication rate.
KW - Adult
KW - Bone Screws
KW - Female
KW - Fracture Fixation, Internal
KW - Humans
KW - Intra-Articular Fractures
KW - Joint Instability
KW - Knee Injuries
KW - Male
KW - Minimally Invasive Surgical Procedures
KW - Posterior Cruciate Ligament
KW - Postoperative Care
KW - Postoperative Complications
KW - Radiography
KW - Surgical Instruments
KW - Suture Anchors
KW - Journal Article
U2 - 10.1007/s00064-012-0208-1
DO - 10.1007/s00064-012-0208-1
M3 - SCORING: Zeitschriftenaufsatz
C2 - 23010885
VL - 24
SP - 348
EP - 353
JO - OPER ORTHOP TRAUMATO
JF - OPER ORTHOP TRAUMATO
SN - 0934-6694
IS - 4-5
ER -