Publication: Positive Pivot Shift Test among Patients with Displaced Anterior Tibial Spine Fractures Undergoing Arthroscopic Fixation in a Tertiary Care Centre: A Descriptive Cross-sectional Study
Date
2023
Journal Title
Journal ISSN
Volume Title
Publisher
Nepal Medical Association
Abstract
Abstract
Introduction: Understanding of displaced anterior tibial spine fractures has evolved over the years and is now considered to be anterior cruciate ligament avulsion injuries rather than intra-articular fractures. However, there are very few studies available evaluating the presence or absence of a pivot shift test, which is specific in diagnosing anterior cruciate ligament insufficiency, in patients with anterior tibial spine fractures. This study aimed to find out the prevalence of the positive pivot shift test among patients with displaced anterior tibial spine fractures undergoing arthroscopic fixation in a tertiary care centre.
Methods: A descriptive cross-sectional study was conducted among patients presented with displaced anterior tibial spine fractures undergoing arthroscopic fixation. The data were collected between 1 January 2020 and 30 May 2022. Ethical approval was obtained from the Institutional Review Committee (Reference number: IRC_2019_11_09_1). All patients who presented with displaced anterior tibial spine fractures undergoing arthroscopic fixation were included in the study and those who did not provide consent were excluded. The pivot test was performed under anaesthesia. Point estimate and 90% Confidence Interval were calculated.
Results: Among 48 patients, pivot shift was positive in 36 (75%) (64.75-85.25, 90% Confidence Interval). The mean age of the participants was 28.97±11.16 years, 21 (58.33%) were males and 15 (41.66%) were females.
Conclusions: The prevalence of positive pivot shift test under anaesthesia in patients with displaced anterior tibial spine fractures undergoing arthroscopic fixation was higher than other studies done in similar settings.
Description
Amit Joshi
Department of Orthopaedics, B&B Hospital Pvt Ltd., Gwarko, Lalitpur, Nepal
Sabin Shrestha
Department of Orthopaedics, Nepalgunj Medical College Teaching Hospital, Kohalpur, Banke, Nepal
Subhash Regmi
Department of Orthopaedics, B&B Hospital Pvt Ltd., Gwarko, Lalitpur, Nepal
Bibek Basukala
Department of Orthopaedics, B&B Hospital Pvt Ltd., Gwarko, Lalitpur, Nepal
Rajiv Sharma
Department of Orthopaedics, B&B Hospital Pvt Ltd., Gwarko, Lalitpur, Nepal
Rohit Bista
Department of Orthopaedics, B&B Hospital Pvt Ltd., Gwarko, Lalitpur, Nepal
Nagmani Singh
Department of Orthopaedics, B&B Hospital Pvt Ltd., Gwarko, Lalitpur, Nepal
Ishor Pradhan
Department of Orthopaedics, B&B Hospital Pvt Ltd., Gwarko, Lalitpur, Nepal
Keywords
Anterior cruciate ligament, Arthroscopy, Knee fractures, Physical examination