Subintermeniscal Ligament Pullout Suture Technique for Anterior Cruciate Ligament Avulsion Fracture Fixation—AIIMS Technique

AbstractMany methods have been described, including pullout suture technique, for arthroscopic fixation of displaced tibial eminence fracture. We are describing our technique of pullout suture, which is a modification of previously described techniques. We passed two sutures arthroscopically through anterior cruciate ligament (ACL) just above the avulsed fragment and then pulled them out through medial and lateral bone tunnel in anterior aspect of crater in tibial plateau. The third suture passed through ACL was pulled out anteriorly under the transverse intermeniscal ligament through a submeniscal route. All sutures were tied under tension to a screw post placed on the anterior tibia after reducing the avulsed bone fragment. Our technique provides good reduction and even overreduction of the fragment. It also provides good initial fixation strength to work against displacing forces even in small and comminuted bony fragment. This is helpful for achieving adequate stability of knee, complete extension of knee, early rehabilitation, and quicker recovery.</jats:p

Management of Neglected Peroneal Tendon Dislocation of Iatrogenic Etiology: A Case Report

Introduction:Neglected peroneal tendon dislocation with iatrogenic etiology has been rarely reported in the literature and its management has not been fully understood to date. Case Report:We present a case of a 25-year-old male who presented with pain over the posterolateral aspect of his left ankle which was diagnosed to be a case of neglected peroneal tendon dislocation of iatrogenic etiology. Peroneal groove deepening with superior retinaculum repair was done in the patient along with loose body removal and osteophyte excision. Subsequent fibrosis augmented with the deepening of the groove maintained peroneal tendon position in the retromalleolar groove. On post-operative follow-up, the patient was completely satisfied with relief of pain and no complications. He also regained full range of motion and could walk without support. Conclusion:Surgical intervention of fibular groove deepening with superior peroneal retinaculum reconstruction results in an excellent outcome for neglected peroneal tendon dislocation Keywords:Peroneal tendon, Superior peroneal retinaculum, Fibular groove.</jats:p