Management of posterior cruciate ligament tibial avulsion fractures using a mini-open Screw fixation technique

Abstract Background Posterior cruciate ligament (PCL) tibial avulsion fractures are relatively infrequent injuries but may result in persistent posterior instability and compromised knee function if not managed appropriately. Methods This prospective case series included 12 patients with isolated PCL tibial avulsion fractures who underwent fixation using a mini-open posterior approach between January 2020 and December 2023. Fractures were classified according to the McKeever classification. Patients were followed clinically and radiologically for a mean duration of 11.25 ± 1.60 months (range, 9–14 months). Functional outcomes were assessed using the International Knee Documentation Committee (IKDC) subjective score, Lysholm knee score, and knee range of motion. Results At final follow-up, all patients demonstrated satisfactory knee stability and functional recovery. The mean IKDC score was 92.75 ± 1.66, and the mean Lysholm score was 93.4 ± 2.1. The mean knee range of motion was 130.75° ± 6.30°. Radiographic union was achieved in all cases, and no major procedure-related complications were observed. Conclusion Mini-open posterior screw fixation is a safe, reproducible, and effective technique for the management of displaced, isolated PCL tibial avulsion fractures, particularly in settings where arthroscopic resources may be limited. Level of Evidence IV (Prospective case series).