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

<h2>Abstract</h2><h3>Background</h3> 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. <h3>Methods</h3> 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. <h3>Results</h3> 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. <h3>Conclusion</h3> 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. <h3>Level of Evidence</h3> IV (Prospective case series).