Exploring PCL Tibial Avulsion Fractures: A Rare Case Series Demonstrating Favorable Outcomes with Mini Open Procedure Using Screw Fixation

Introduction: Posterior cruciate ligament (PCL) tibial avulsion fractures are rare and often underdiagnosed injuries, typically affecting young, active individuals following high-energy trauma. Surgical fixation is essential, but optimal techniques depend on fragment size and morphology. Case Presentation: We report three cases of isolated PCL tibial avulsion fractures in young adults managed via a mini-open posterior approach. Injuries were confirmed clinically and radiologically. Fixation methods were tailored to fragment characteristics. Discussion: All patients achieved good short-term outcomes, with Lysholm scores of 86, 88, and 89 at three months postoperatively. Larger fragments were successfully stabilized with screw fixation. No complications related to neurovascular structures or fixation failure were observed. Conclusion: Mini-open fixation is a safe and effective technique for managing PCL tibial avulsion fractures. Individualized fixation strategies based on fragment size and early rehabilitation contribute to favorable functional outcomes. Keywords: PCL, avulsion fracture, tibial insertion, mini-open approach, fixation, Lysholm score