Clinical and Functional Outcomes of Open Reduction and Internal Fixation in Isolated Posterior Cruciate Ligament Avulsion Fracture

Background: Avulsion fractures of the posterior cruciate ligament (PCL) are uncommon injuries that, if not treated properly, can cause persistent knee instability and early degenerative effects. Objective: To evaluate the clinical, functional, and radiological outcomes of open reduction and internal fixation (ORIF) in patients with isolated PCL tibial avulsion fractures. Patients and Methods: This retrospective observational study was conducted at Zagazig University Hospitals, included 12 patients with displaced PCL tibial avulsion fractures. All patients underwent open reduction and internal fixation with cannulated cancellous screws via a posteromedial route. Patients were followed for at least six months. Clinical outcomes were measured using the posterior drawer test and knee range of motion, whereas functional outcomes were evaluated using the Lysholm Knee Scoring System. Radiological union was tested using serial radiographs. Results: The average age of patients was 28.9±7.6 years, with men accounting for 91.7%. At six months, all patients demonstrated significant improvement in posterior knee stability, with a negative posterior drawer test (p < 0.001). Radiological union was obtained in all patients after one month and remained stable during follow-up (p<0.001). Functional outcomes improved significantly, with mean Lysholm scores rising from 36.3±4.8 preoperatively to 96.1±3.2 at six months (p < 0.001). Postoperative problems occurred in 16.7% of individuals. Conclusion: Open reduction and internal fixation with cannulated cancellous screws utilizing a posteromedial approach is a safe, successful, and dependable method for treating solitary PCL avulsion fractures. Early surgical intervention, combined with structured rehabilitation, produces excellent stability, fracture union, and positive functional outcomes. ？