• Ahmed A Khalifa, Mohamed Eslam Elsherif, Essam Elsherif, and Omar Refai.
• Orthopaedic Department, Assiut university hospital, Assiut, Egypt; Orthopaedic Department, Qena faculty of medicine and its university hospital, South valley university, Qena, Egypt. Electronic address: ahmed_adel0391@med.svu.edu.eg.
• Injury. 2021 Mar 1; 52 (3): 594-601.

PurposeThe purpose of our study was to evaluate the clinical and radiological outcomes after ORIF of PCL tibial insertion avulsion through the modified direct posterior approach using a small set plate and screws.MethodsBetween January 2017 to September 2019, 31 patients with isolated PCL tibial insertion bony avulsion were identified. Twenty-one (68%) patients presented within one week of the injury, 8 (26%) patients presented after injury by a mean 7.5 weeks (range 3:12), and two (6%) patients presented late at 7- and 9-months after injury.ResultsThe mean age was 28.3 ± 6.3 years, 26 (84%) males, and 5 (16%) females. The mean operative time was 39.8 ± 7.9 min. In all patients, a one-third tubular plate was used. Fracture union was achieved in all patients after a mean 8 ± 2.1 weeks. The mean knee flexion at last follow up was 120.7° ± 4.3 with full extension in all patients. The knee Lysholm scoring was excellent in 27 (87%) patients, good in 3 (10%) patients, and fair in one (3%); the mean score was 93.4 ± 3.9. The PDT was positive in 4 patients (13%), three grade I, and one grade II. No neurovascular bundle or hardware related complications were reported. Two (6.5%) patients had a superficial wound infection with no further intervention.ConclusionUsing small set plates and screws for ORIF of PCL tibial avulsion fractures through a direct posterior approach revealed good results in terms of surgical exposure, safety, radiological and clinical outcomes.Copyright © 2020 Elsevier Ltd. All rights reserved.

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