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Year |
2001 |
|---|---|
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Question Number |
89 |
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Category |
Select |
Question
A 30 year old professional soccer player sustains a midshaft fracture of the tibia and fibula. History reveals that the patient underwent a successful anterior cruciate ligament reconstruction with central one third bone-patellar tendon-bone autograft and graft fixation with interference screws 2 years ago. Figures 22A and 22b show the pre- and postoperative radiograph. What is the most likely postoperative complication in this patient?
1. loss of graft fixation
2 fracture through the tibial tunnel
3. galvanic corrosion (battery effect)
4. anterior knee pain
5. saphenous neuralgia
Figures
Answer (click for answer)
The correct answer is 4. A potential clinical problem after both intramedullary nailing of tibial fractures and ACL reconstruction is the high incidence of anterior knee pain. Anterior knee pain
is reported in up to 57% of patients after intramedullary nailing of tibia-fibula fractures and in 5-50% of patients after ACL reconstruction. It not known whether a patient who has undergone both procedures has an additive or an exponential risk of anterior knee pain. The number 1 and 2 answers can be prevented by preoperative assessment of the previous ACL graft tunnel and hardware location to determine the course of intramedullary nailing instruments. (Arthroscopy)
Reference: Arthroscopy 1998; 14: 779-783