An ultrasound-assisted technique to fix the avulsion fracture of the posterior tibial spine

Background: The fixation of posterior tibial avulsion fractures has been predominantly open reduction and internal fixation that leads to longer incision, severe scarring and higher risk to neurovascular injury while using the posterior approach. The arthroscopic methods have a steep learning curve...

Full description

Bibliographic Details
Main Authors: Gautam Kumar, Biju Jacob, Jefin Jose Edakalathur, Lazar J Chandy, Rajesh Simon
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2023-01-01
Series:Journal of Orthopedics, Traumatology and Rehabilitation
Subjects:
Online Access:http://www.jotr.in/article.asp?issn=0975-7341;year=2023;volume=15;issue=1;spage=44;epage=49;aulast=Kumar
_version_ 1797773789136683008
author Gautam Kumar
Biju Jacob
Jefin Jose Edakalathur
Lazar J Chandy
Rajesh Simon
author_facet Gautam Kumar
Biju Jacob
Jefin Jose Edakalathur
Lazar J Chandy
Rajesh Simon
author_sort Gautam Kumar
collection DOAJ
description Background: The fixation of posterior tibial avulsion fractures has been predominantly open reduction and internal fixation that leads to longer incision, severe scarring and higher risk to neurovascular injury while using the posterior approach. The arthroscopic methods have a steep learning curve, and fracture fixation is usually with fibre wire. Aim: Ultrasound assisted fixation of PCL avulsion fracture. Material and Methods: The patient is placed prone; the limb is placed in 20-degree flexion and neutral rotation. The US is used to identify the popliteal artery and nerve. The blunt tip of a K wire is inserted under US guidance. After confirming the position with an image intensifier, a 3.5 mm cannulated screwdriver is passed over the K wire. The final reduction is confirmed with image intensifier in anteroposterior and lateral views. Results: We present 11 cases of the posterior tibial avulsion fracture, which have been fixed with percutaneous screw fixation. The procedure was done under image intensifier guidance and ultrasound assistance. We have a minimum 1 year and a maximum of 10 years of follow up, where most of the patients had an excellent outcome. Conclusion: The authors felt with the ultrasound-assisted fixation technique, there is minimal or no scarring with stronger fixation. The procedure is safe, devoid of morbidities associated with open reduction and can be easily replicated at most trauma centers.
first_indexed 2024-03-12T22:11:34Z
format Article
id doaj.art-028aef08b31749fd97245eee6228dfe2
institution Directory Open Access Journal
issn 0975-7341
language English
last_indexed 2024-03-12T22:11:34Z
publishDate 2023-01-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Journal of Orthopedics, Traumatology and Rehabilitation
spelling doaj.art-028aef08b31749fd97245eee6228dfe22023-07-23T11:42:00ZengWolters Kluwer Medknow PublicationsJournal of Orthopedics, Traumatology and Rehabilitation0975-73412023-01-01151444910.4103/jotr.jotr_58_21An ultrasound-assisted technique to fix the avulsion fracture of the posterior tibial spineGautam KumarBiju JacobJefin Jose EdakalathurLazar J ChandyRajesh SimonBackground: The fixation of posterior tibial avulsion fractures has been predominantly open reduction and internal fixation that leads to longer incision, severe scarring and higher risk to neurovascular injury while using the posterior approach. The arthroscopic methods have a steep learning curve, and fracture fixation is usually with fibre wire. Aim: Ultrasound assisted fixation of PCL avulsion fracture. Material and Methods: The patient is placed prone; the limb is placed in 20-degree flexion and neutral rotation. The US is used to identify the popliteal artery and nerve. The blunt tip of a K wire is inserted under US guidance. After confirming the position with an image intensifier, a 3.5 mm cannulated screwdriver is passed over the K wire. The final reduction is confirmed with image intensifier in anteroposterior and lateral views. Results: We present 11 cases of the posterior tibial avulsion fracture, which have been fixed with percutaneous screw fixation. The procedure was done under image intensifier guidance and ultrasound assistance. We have a minimum 1 year and a maximum of 10 years of follow up, where most of the patients had an excellent outcome. Conclusion: The authors felt with the ultrasound-assisted fixation technique, there is minimal or no scarring with stronger fixation. The procedure is safe, devoid of morbidities associated with open reduction and can be easily replicated at most trauma centers.http://www.jotr.in/article.asp?issn=0975-7341;year=2023;volume=15;issue=1;spage=44;epage=49;aulast=Kumarminimally invasive techniqueposterior tibial avulsion fracturesultrasound-assisted fixation
spellingShingle Gautam Kumar
Biju Jacob
Jefin Jose Edakalathur
Lazar J Chandy
Rajesh Simon
An ultrasound-assisted technique to fix the avulsion fracture of the posterior tibial spine
Journal of Orthopedics, Traumatology and Rehabilitation
minimally invasive technique
posterior tibial avulsion fractures
ultrasound-assisted fixation
title An ultrasound-assisted technique to fix the avulsion fracture of the posterior tibial spine
title_full An ultrasound-assisted technique to fix the avulsion fracture of the posterior tibial spine
title_fullStr An ultrasound-assisted technique to fix the avulsion fracture of the posterior tibial spine
title_full_unstemmed An ultrasound-assisted technique to fix the avulsion fracture of the posterior tibial spine
title_short An ultrasound-assisted technique to fix the avulsion fracture of the posterior tibial spine
title_sort ultrasound assisted technique to fix the avulsion fracture of the posterior tibial spine
topic minimally invasive technique
posterior tibial avulsion fractures
ultrasound-assisted fixation
url http://www.jotr.in/article.asp?issn=0975-7341;year=2023;volume=15;issue=1;spage=44;epage=49;aulast=Kumar
work_keys_str_mv AT gautamkumar anultrasoundassistedtechniquetofixtheavulsionfractureoftheposteriortibialspine
AT bijujacob anultrasoundassistedtechniquetofixtheavulsionfractureoftheposteriortibialspine
AT jefinjoseedakalathur anultrasoundassistedtechniquetofixtheavulsionfractureoftheposteriortibialspine
AT lazarjchandy anultrasoundassistedtechniquetofixtheavulsionfractureoftheposteriortibialspine
AT rajeshsimon anultrasoundassistedtechniquetofixtheavulsionfractureoftheposteriortibialspine
AT gautamkumar ultrasoundassistedtechniquetofixtheavulsionfractureoftheposteriortibialspine
AT bijujacob ultrasoundassistedtechniquetofixtheavulsionfractureoftheposteriortibialspine
AT jefinjoseedakalathur ultrasoundassistedtechniquetofixtheavulsionfractureoftheposteriortibialspine
AT lazarjchandy ultrasoundassistedtechniquetofixtheavulsionfractureoftheposteriortibialspine
AT rajeshsimon ultrasoundassistedtechniquetofixtheavulsionfractureoftheposteriortibialspine