Avulsión de espina tibial posterior en el adulto. Resolución quirúrgica con técnica de “pull-out”: reporte de un caso

Abstract

Introduction: avulsion of the posterior tibial spine in adults represents an infrequent form of compromise of the posterior cruciate ligament (PCL), more common to see in the pediatric population. The possibility of consolidation of this lesion, with adequate treatment early, depends on an early diagnosis.

Case: we report the case of a 27-year-old patient with a multiligamentary knee injury with medial and posterior instability, due to high-energy trauma after suffering a motorcycle traffic accident. Which was treated with an open fixation with a “pull-out” technique.

Discussion: in Asian countries it is a frequent injury due to the high prevalence of motorcycle accidents, being less common in our continent. Although early surgical management shows better results, there is no current consensus regarding the optimal technique. Both types of resolution (open and arthroscopic) show similar long-term results, with a higher risk of arthrofibrosis in the last group.

Conclusion: as there is controversy over its surgical management, we believe that the combination of the advantages of both techniques (open and arthroscopic) constitutes a reproducible, low-cost option with a low rate of complications.