Arthroscopic reduction and internal fixation of an avulsion fracture of the posterior horn of the lateral meniscus

Abstract

We report a very rare case of an avulsion fracture of the posterior horn of the lateral meniscus associated with ACL tear, which was successfully treated by arthroscopic reduction and pullout fixation of the fragment along with ACL reconstruction.

Long-term Evaluation of Posterior Lateral Meniscus Root Tears Left In Situ at the Time of Anterior Cruciate Ligament Reconstruction

“…While the risk is known, what remains to be seen is whether attempts at repairing PLMR tears are successful via surgical fixation. At present there are few reports of surgical fixation of PLMR tears, 1,3,11,15,21 and only 1 of these describes long-term follow-up. 15 Nicholas et al 21 described a surgical technique for repairing both medial and lateral meniscus root tears but no patient results were reported.…”

“…15 In addition, only limited reports are available to substantiate whether surgical techniques can afford lasting fixation and function of the root avulsion. 11 Furthermore, there is no evidence at present to suggest that repairing PLMR tears offers long-term clinical improvement over leaving them in situ at the time of ACL reconstruction.…”

Arthroscopic Repair of the “Tibial Avulsion Triad”—ACL Posterolateral Bundle, PCL, and Lateral Meniscus Posterior Root: The Triple Tunnel Technique

“… 4 There has been one case report of a bony avulsion of the posterior root of the lateral meniscus in conjunction with a tear of the ACL, and none, to our knowledge, in the context of a PCL tibial avulsion fracture. 17 The additional ACL PLB tibial peel-off injury described in this technique note thus presents an extremely rare variant of PCL avulsion injuries that we termed the “tibial avulsion triad”.…”

Case report of concomitant avulsion fractures of the medial meniscus and posterior cruciate ligament

“…Open and arthroscopic fixation techniques were described for the fixation method of both PCL and meniscus avulsion fractures. [13,[19][20][21] We decided to perform both PCL and meniscus fixation with the posterior approach described by Burks et al [8] In this approach, the interval between the semimembranosus and medial head of the gastrocnemius is used, and neurovascular structures were protected by retracting the gastrocnemius laterally. The visualization and management of the fracture are more challenging than other previously described approaches, but allowing faster rehabilitation protocol is advantageous.…”