Abstract :
Variations in the arterial pattern of the upper limb are very common as observed in many cadaveric and angiographic
studies. Knowledge of variations in the origin and course of the radial artery is important because they are used for
many diagnostic procedures as well as vascular and reconstructive surgeries like coronary angiography, percutaneous
coronary intervention and coronary artery bypass surgery. During routine dissection in our institute, we observed a case
of high origin of the radial artery in a 33 year old male cadaver. It was found to be unilateral; on left side, radial artery
was taking origin from 3rd part of the axillary artery at the lower border of pectoralis minor before the origin of
subscapular artery and anterior circumflex humeral artery. It had a superficial course in the arm crossing the median
nerve from medial to lateral side. The further course of this superficial radial artery in the forearm was normal and it
terminated by forming a deep Palmar arch in hand. These variations may be of great clinical implications for vascular
and plastic surgeons and radiologists. Superficial course of radial artery makes it vulnerable to accidental injuries.
INTRODUCTION
Isolated PCL avulsion fractures are uncommon.
The road traffic accidents (RTA), sports injuries are
common causes along with domestic trauma. The
mode of trauma is specific in PCL injuries and
include dashboard, hyperextension and hyperflexion
injuries.[1] The aim of treating PCL avulsion
fractures is to prevent the disability and long-term
development of medial compartment and
patellofemoral arthritis. Many studies[2,3] have
demonstrated that the chronic PCL insufficiencies
may result in medial and patellofemoral
compartments, degenerative arthritis and increased
risk of meniscal tears.
Name & Address of Corresponding Author
PinkiRai
Demonstrator,
Department of Anatomy,
SHKM Govt. Medical College, Nalhar (Nuh), India.
E mail:
[email protected]
Various studies are present indicating the actual
percentages of PCL injuries with respect to mode
of injury. Anatomically PCL acts as a posterior
knee stabilizer and limits the posterior tibial
translation.[1,4,5] PCL injuries are estimated to
account for 20% of knee ligament injuries. Higher
incidence is seen in cases resulting from highenergy
trauma, such as road traffic accidents, and
in an athletic population, this injury is more closely
associated to contact sports.[6,7] Domestic trivial
injuries forms a less sizable group
Torisu et al[8] have mentioned that the neglected
and delayed beyond 11 weeks , the PCL avulsion
fractures have poor results. Griffith et al[9] in
Arthroscopy 2004 , strongly advocated fixation of
displaced PCL avulsion fractures to avoid the
morbidities associated PCL avulsion fracture
nonunion. Literature suggests controversial treatment
protocols in PCL tibial avulsion fractures but
generally surgical reinsertion of the avulsioned
fragment is a recommended procedure.[7-9]
We focused our study specifically on isolated PCL
avulsion fractures so that we can obviate the
Name & Address of Corresponding Author
Dr. Nilesh Vishwakarma,
DND, D’Orth, Fellowship in Sports Medicine (Brasil)
203, Sai Vishwakarma Darshan,
Shahaji Raje Marg, Vile Parle East, Mumbai-57
Background: Isolated PCL avulsion fractures are uncommon. The road traffic accidents (RTA), sports injuries
are common causes along with domestic trauma. Methods: We conducted a prospective study with sample size
of 34 patients to evaluate the outcome of isolated PCL avulsion fractures treated with cancellous cannulated
screws over washers. Results: Our study included 47.06% RTA, 26.47% sports trauma and 26.47% domestic
injuries. Standard Burks schaffers approach was used in all 34 cases. Delayed union was found in 5.88 %
beyond 16 weeks although none needed revision or reconstruction. The delayed union was obvious in patients
with comminuted fractures, which were fixed with washers on screws along with pull through sutures. All the
cases were evaluated using Lysholm, IKDC and objective PDT manual examination. Conclusion: The isolated
PCL avulsion fractures treated with fixation have good Lysholm and IKDC scores, although objective laxity is
present in significant number of cases without subjective disability. The isolated PCL injuries have good results if
managed surgically.
Keyword :
Isolated PCL avulsion fractures.