Clinical Efficacy of a Modified Posteromedial Oblique Incision in the Treatment of Posterior Cruciate Ligament Tibial Avulsion Fractures: A Single-centre, Single-arm, Prospective Study.

Abstract

Aims: The purpose of the study was to evaluate the safety and efficacy of a modified posteromedial oblique incision (POI) in the treatment of posterior cruciate ligament (PCL) tibial avulsion fractures.

Methods: A single-centre, single-arm, prospective study. Patients who met the inclusion criteria were collected between September 2022 and June 2024 at the First Affiliated Hospital of Guangxi Medical University. Patients were followed up to the study endpoint, and the safety and efficacy of the POI were inferred by analysing the follow-up data.

Results: The angle was 67.20 ± 3.16°, the |OM| was 2.48 ± 0.13 cm, the |ON| was 1.33 ± 0.12 cm. The incision length was statistically significant when compared with the two classic incisions, the 'S' and the inverted 'L' (P < 0.05). The difference in the comparison of KT-1000, Lysholm scores, International Knee joint Documentation Committee scores and posterior drawer test negative rate in pre-surgery and 3 months post-surgery were statistically significant (P < 0.05). The KT-1000 of the normal knee, the normal calf circumference, and the pre-surgery calf circumference were compared with the knee 3 months post-surgery, respectively, and the differences were not statistically significant (P > 0.05). Gastrocnemius strength in all patients was determined to be grade 5, which is normal strength.

Conclusion: The study has shown that using POI to treat PCL tibial avulsion fractures is safe and effective, because it avoids nearby nerves and blood vessels. Therefore, I believe that the modified POI technique is worthy of being considered for use and has a great potential for application.