Small medial-posterior"S"incision and absorbable threaded anchor pin"button type"suture for the treatment of efficacy of posterior cruciate ligament tibial avulsion fractures in children and adolescents

WANG Bo-kai; WU Yi-heng; ZHANG Jin-long; ZHAO Hong-bo; LI Jun-ran; ZHOU Hong-yan

doi:10.3969/j.issn.2095-252X.2025.06.003

Abstract：Objective To evaluate the outcome of the"button type"suture method of applying absorbable threaded anchor nails through a small S incision on the medial side of the knee joint in treatment of tibial avulsion fracture of posterior cruciate ligament in children and adolescents.Methods From August 2020 to October 2023,15 children with avulsion fracture of tibial insertion of posterior cruciate ligament were treated in Tangshan Second Hospital.After fracture reduction with small S incision on the posterior medial side of the knee joint,two absorbable suture anchors were used for"button like"suture fixation.There were 12 males and 3 females;the age ranged from 10 to 18 years;there were 10 cases on the left side and 5 cases on the right side;all of them were fresh fractures.After surgery,they underwent stepped rehabilitation exercise.Lysholm score was used to evaluate the knee joint function,and postoperative X-ray film was used to evaluate the fracture healing.Results All the 15 children achieved satisfactory reduction,and the X-ray film showed bone healing within 3 months after operation.All the children had no serious complications such as fracture re displacement,implant loosening,fracture nonunion,infection,etc.the postoperative follow-up time was 6-18 months,and the Lysholm knee function score was(95.4±1.9)points at the last follow-up.According to the clinical data obtained at the last follow-up as the basis for postoperative functional evaluation,the Lysholm score of bilateral knees,the length of both lower limbs,Lachmann test,and axial displacement test were used to evaluate the knee function.Compared with the healthy side,the differences were not statistically significant(P>0.05).There were no complaints including knee pain,instability,flabby legs,limited mobility,knee deformity,premature epiphyseal closure,limb shortening and other deformities.Conclusions The small S incision on the medial side of the knee does not need to separate the neurovascular structure of the popliteal fossa,with less bleeding and wide field of vision.The absorptive threaded anchor"button type"suture can fix all types of fractures with reliable fixation,which is good for early postoperative rehabilitation to minimize the disability caused by these injuries.