Refixation of Tibial Bony Avulsions of the Posterior Cruciate Ligament with a Hook Plate

Abstract

Posteromedial approach to the knee. Exact reduction and fixation of avulsed tibial attachment of posterior cruciate ligament with small-fragment plate. Avulsed tibial attachment of posterior cruciate ligament. Ligamentous rupture of the posterior cruciate ligament. Local soft-tissue problems. Posteromedial approach with mobilization and retraction of the medial gastrocnemius muscle. Subperiosteal detachment of the popliteal muscle. Identification of fracture site. Longitudinal incision of the posterior capsule of the knee. Debridement of the fracture site, reposition and stabilization with small-fragment plate. Partial weight bearing with 15 kg for 6 weeks, limitation of knee flexion to 90° for 6 weeks. A special joint orthesis is not necessary. The use of an EMT unit is recommended to prevent muscular atrophy. Six patients (four female, two male) with avulsed tibial attachment of posterior cruciate ligament were treated using the posteromedial approach.