Publication:

Clinical and functional outcome of isolated posterior cruciate ligament avulsion fractures treated by open reduction and internal fixation

Background PCL ligament avulsion fracture injuries constitute about 3-20% of all the knee injuries. Isolated posterior cruciate ligament injuries are uncommon and often go undiagnosed in acutely injured knees. fracture. In the long run they cause severe functional disability of the knee joint. There is no consensus concerning the optimal surgical treatment approach for these injuries. Our study was to assess the functional and clinical outcome of isolated PCL avulsion fractures with open reduction and internal fixation.

Methods This is a prospective study of 27 patients with isolated PCL avulsion fractures, done in the department of orthopaedics in RNT medical college over a 2-year period. All were treated with open reduction and internal fixation with 4 mm cannulated cancellous screw and washer. Postoperatively, patient leg was immobilized in posterior POP slab for 2 weeks, allowing toe touch weight bearing. All patients were regularly followed-up. 3 cases of post operative wound infection were detected.

Results Of the 27 patients, there were 19 males and 8 females. All the cases showed good fracture union in an average of 12 weeks post operatively. In the first 6 weeks, all of them acquired an average knee flexion of 90 degrees and by 3 months, all of them had 125 degrees of free flexion possible.2 cases showed negative posterior draw sign. The knee scoring system assessment showed 21 cases of excellent result, 4 cases of good result and 2 cases of fair result.

Conclusions Though rare, PCL avulsion fractured are to be managed properly and treated surgically. PCL tibial avulsion fractures treated through Burk and Schaffer approach with open reduction and internal fixation produces good results.