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European Journal of Orthopaedic Surgery & Traumatology

23-04-2024 | General Review

Management of pediatric posterior cruciate ligament avulsion fractures: a systematic review

Authors: Christopher Jayne, Giovanna Medina, Brian Grottkau, Nikolaos Paschos

Published in: European Journal of Orthopaedic Surgery & Traumatology

Abstract

Purpose

Both open and arthroscopic surgical techniques have been used for PCL avulsion fractures. The goal of this study is to evaluate the effectiveness and safety of the different management strategies proposed for PCL avulsion fractures in children.

Methods

A systematic literature review was performed utilizing Medline, Scopus, and EMBASE databases from 1977 to the present. PRISMA guidelines were followed. Data were selected and extracted by two independent reviewers. Inclusion criteria were clinical studies reporting injuries in pediatric patients with PCL avulsion injuries. Exclusion criteria were combined PCL and ACL injuries and ligamentous injuries requiring reconstruction. A subgroup analysis was performed between open reduction and arthroscopic surgeries.

Findings/Results

Twenty-six studies were included in this systematic review. Patient sex was reported in 39 patients with a higher number of males (32/39). The age range was 7–18 years old. In the open group, 30/31 patients had clinical improvement or returned to pre-injury activity level with two complications. Lysholm scores ranged from 66 to 99. In the arthroscopic group, 11/12 patients experienced clinical improvement or returned to normal activity levels with only one complication. Lysholm scores ranged from 90 to 100 with a mean of 95. In the non-operative group, 3/3 recovered with evidence of fracture healing, full or near full knee range of motion. One Lysholm score was reported 14 months after injury and was 100/100.

Conclusions

Open reduction and arthroscopic surgeries are effective and safe treatment options for pediatric PCL avulsion fractures—97% of open reduction and 92% of arthroscopic patients significantly improved symptoms. The complication rates for the open and arthroscopic groups were 11 and 9%, respectively. All three non-operative made full or near full recovery of pre-injury knee status.

Level of evidence IV

Systematic review of Level-II–IV studies.

Prospero Registration No CRD42021290899.

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Title: Management of pediatric posterior cruciate ligament avulsion fractures: a systematic review
Authors: Christopher Jayne
Giovanna Medina
Brian Grottkau
Nikolaos Paschos
Publication date: 23-04-2024
Publisher: Springer Paris
Published in: European Journal of Orthopaedic Surgery & Traumatology
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-024-03920-y

At a glance: The STEP trials

Springer Medicine

Management of pediatric posterior cruciate ligament avulsion fractures: a systematic review

Abstract

Purpose

Methods

Findings/Results

Conclusions

Level of evidence IV

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Findings/Results

Conclusions

Level of evidence IV

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