Management of comminuted tibial end bony avulsion of posterior cruciate ligament by open posterior approach using suture bridge technique: A case series.

Background: Comminuted tibial end bony avulsion of posterior cruciate ligament (PCL) is a challenging problem in terms of accurate reduction, fixation and union to provide a stable knee. Arthroscopic reduction or a screw fixation is good option for a large fragment but comminuted fragment reduction remains a challenge. Suture bridge technique using two anchors can provide an accurate reduction and stable fixation.

Method: 10 patients of isolated comminuted PCL avulsion with a mean age of 30 years were fixed by standard posterior approach using suture bridge technique.

Results: Mean follow up was 12 months. All patients showed radiological union at 12 weeks with a mean Lysholm score of 92. Seven out of ten achieved IKDC grade A and remaining three had grade B. No complication of the procedure were noted.

Conclusion: Suture bridge technique is an excellent option to fix a comminuted PCL avulsion fracture where arthroscopic reduction or open single screw fixation is not a viable due option due to comminution.