Fixation of posterior cruciate ligament avulsion fracture with the use of a suspensory fixation.

Purpose: Posterior cruciate ligament (PCL) avulsion fractures are uncommon injuries, and their treatment, still, remains difficult. There are procedures described in the literature which are minimal invasive and use either sutures or screws to stabilize the avulsed fragment. The purpose of this study was to present an innovative arthroscopic technique using a suspensory device with specific biomechanical properties. The aim of this study was to determine whether this technique was effective in the treatment of PCL avulsion fractures and applicable in everyday clinical practice.

Methods: Two patients with an isolated posterior cruciate ligament avulsion fracture were operated under arthroscopy. The Endobutton device was used to stabilize the fracture, and a double-spike plate was used to secure the fixation. The clinical assessment of patients was made by plain radiographs, CT scan, MRI and IKDC examination form.

Results: The median operative time was 57.5 min (range 55-60). No posterior tibial sag was noticed, and the range of motion was normal. No complications were recorded, and both patients returned to their usual daily activities. Both fractures had healed at 10 months postoperatively.

Conclusions: Treatment outcomes using a suspensory device in the fixation of posterior cruciate ligament avulsion fractures are encouraging. The small size of the device makes it easy to handle, and the procedure is simple and does not require multiple sutures and bony tunnels. This technique offers sufficient compression, restores the length of posterior cruciate ligament and can fix avulsion fragments of any size.

Level Of Evidence: Therapeutic study, Case series with no comparison group, Level IV.