Adjustable-loop cortical suspension device for posterolateral corner reconstruction in the setting of fibular avulsion fracture: a case series and novel technique description

Arch Orthop Trauma Surg. 2023 Apr;143(4):1981-1987. doi: 10.1007/s00402-022-04412-6. Epub 2022 Mar 19.

Abstract

Introduction: A novel technique using an adjustable-loop cortical suspension toggle device for reduction of a fibular head avulsion fracture (arcuate fracture) in posterolateral corner (PLC) reconstruction is described. Results of clinical follow-up are presented.

Materials and methods: 9 patients were retrospectively identified who underwent posterolateral corner reconstruction using an adjustable-loop cortical suspension toggle device. Radiographic examination was used to evaluate the successful healing of the avulsed fibular head fragments post-operatively.

Results: 7 patients reported satisfactory results with their clinical outcome with no feelings of knee instability or objective instability on exam at final follow-up. Post-operative radiographs obtained > 6 months following reconstruction demonstrated well reduced and healed fracture in 5 of 6 patients, with 1 patient demonstrating maintained reduction but incomplete fracture union at 6 months.

Conclusion: This novel surgical technique for PLC reconstruction with an avulsed fibular head fracture is a viable alternative to previously described methods. The majority of patients report subjective satisfaction with a stable knee post-operatively.

Level of evidence: IV.

Keywords: Arcuate fracture; Fibular head avulsion; Posterolateral corner reconstruction.

MeSH terms

  • Fractures, Avulsion* / surgery
  • Fractures, Bone*
  • Humans
  • Knee Injuries* / surgery
  • Knee Joint / surgery
  • Retrospective Studies