Yoshida K, Hakozaki M, Kobayashi H, Kimura M, Konno S. Surgical treatment for a combined anterior cruciate ligament and posterior cruciate ligament avulsion fracture: A case report. World J Clin Cases 2022; 10(12): 3879-3885 [PMID: 35647157 DOI: 10.12998/wjcc.v10.i12.3879]
Corresponding Author of This Article
Michiyuki Hakozaki, MD, PhD, Professor, Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima-shi, Fukushima 960-1295, Japan. paco@fmu.ac.jp
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Katsuhiro Yoshida, Michiyuki Hakozaki, Hideo Kobayashi, Shinichi Konno, Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
Katsuhiro Yoshida, Michiyuki Hakozaki, Higashi-Shirakawa Orthopaedic Academy, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
Hideo Kobayashi, Department of Orthopaedic Surgery, Sukagawa Hospital, Fukushima 962-0022, Japan
Masashi Kimura, Gunma Sports Medicine Research Center, Zenshukai Hospital, Gunma 379-2115, Japan
Author contributions: Yoshida K performed the patient's surgery and wrote the manuscript; Kimura M was involved in the patient care, manuscript preparation, and review; Hakozaki M, Kobayashi H, and Konno S were involved in the manuscript preparation and review; and All authors read and approved the final manuscript.
Informed consent statement: Written informed consent for the publication of his case was obtained from the patient.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Michiyuki Hakozaki, MD, PhD, Professor, Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima-shi, Fukushima 960-1295, Japan. paco@fmu.ac.jp
Received: September 8, 2021 Peer-review started: September 8, 2021 First decision: December 27, 2021 Revised: February 9, 2022 Accepted: March 6, 2022 Article in press: March 6, 2022 Published online: April 26, 2022
Abstract
BACKGROUND
Independent avulsion fractures with anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL) attachment are relatively common among tibial intercondylar eminence fractures, and their postoperative outcomes are generally favorable. Conversely, huge avulsion fractures of the intercondylar eminence containing the attachment site of both the ACL and the PCL are extremely rare, and the reported clinical outcomes are poor.
CASE SUMMARY
We describe a 30-year-old Japanese male's huge avulsion fracture of the intercondylar eminence of a tibia containing the attachment site of both the ACL and PCL, together with a complete tear of the medial collateral ligament and a partial tear of both the medial and lateral menisci caused by a fall from a high place. All of these injuries were treated surgically, with anatomical reduction and stable fixation. The limb function at 1 year post-surgery was excellent (Lysholm score: 100 points).
CONCLUSION
Although this patient's complete surgical repair was complex, it should be performed in similar cases for an excellent final clinical outcome.
Core Tip: Avulsion fractures of the tibial intercondylar eminence containing the attachment site of both the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) are extremely rare, and the reported clinical outcomes are poor. We report a case of combined knee injury of ACL and PCL avulsion fracture together with a tear of the medial collateral ligament and both the medial and lateral menisci. All of these injuries were treated surgically, with anatomical reduction and rigid fixation. The limb function at 1 year post-surgery was excellent.
