Single-Stage Arthroscopy-Assisted Reduction and Internal Fixation (ARIF) of Tibial Rim Fracture With Posterior Cruciate Ligament Reconstruction and Repair of Posterolateral Complex and Meniscal Injury

ABSTRACT: Multiligament knee injury with periarticular fractures are high-velocity injuries and generally require a staged treatment approach that involves multiple hospitalizations and results in delayed return to activity. We report a single-stage management technique for these injuries with arthroscopy-assisted reduction and internal fixation of a depressed tibial rim fracture with concomitant posterolateral complex repair, medial meniscal repair, and posterior cruciate ligament reconstruction. Technique Video Video 1 This video demonstrates single stage arthroscopy-assisted reduction and internal fixation of tibial rim fracture with posterior cruciate ligament (PCL) reconstruction and repair of posterolateral complex and meniscal injury. Examination under anaesthesia revealed a grade III PCL and posterolateral complex injury confirmed on imaging along with a depressed fracture of the anteromedial tibial rim. The first step in our technique is to address the depressed fracture with elevation and bone grafting under arthroscopy assistance and also to fix the fibular head avulsion using a cannulated cancellous screw and tension band wiring. In the second step, the medial meniscal tear is addressed using all-inside technique and inside-out technique and the PCL is reconstructed using hamstring graft. The third step is to stabilize the elevated tibial rim using a buttress plate.

SUBMITTER: Sundararajan S 

PROVIDER: S-EPMC8626630 | biostudies-literature |

REPOSITORIES: biostudies-literature