Surgical Management of Posterior Cruciate Ligament Avulsion Fracture: A Case Report

Authors

  • Komang Septian Sadiwidayat
  • Febyan Orthopaedic Surgery Resident, Prof. Dr. IGNG Ngoerah General Hospital, Faculty of Medicine, Udayana University, Bali, Indonesia
  • Dominicus Dimitri

DOI:

https://doi.org/10.26911/theijmed.2024.09.01.06

Abstract

Background: Posterior Cruciate Ligament (PCL) avulsion fractures are relatively rare but significant injuries to the knee. The diagnosis and management of these injuries can be complex and require a comprehensive approach

Case Presentation: A 24-year-old female presented to the emergency department following a motorbike fall. She experienced significant pain in her knee and had a swollen popliteal fossa. Imaging studies, including X-ray and CT scan, revealed an avulsion fracture at the PCL insertion. The patient underwent successful surgical fixation of the avulsed fragment, following a positive posterior drawer, sag, and dial test suggesting an isolated PCL avulsion.

Conclusion: This case underscores the importance of a comprehensive and individualized approach to the management of PCL avulsion fractures. It further emphasizes the need for future research to delineate the long-term outcomes of different treatment strategies and to develop evidence-based guidelines for this unique and challenging injury.

Keywords: posterior cruciate ligament, avulsion fracture, knee injury, surgical fixation.

References

Guo H, Zhao Y, Gao L, Wang C, Shang X, Fan H (2023). Treatment of avulsion fracture of posterior cruciate ligament tibial insertion by minimally invasive approach in posterior medial knee. Front in Surg. 9:1-9. DOI: 10.3389/fsurg.2022.885669

Hooper PO, Silko C, Malcolm TL, Farrow LD (2017). Management of posterior cruciate ligament tibial avulsion injuries: A Systematic Review. 46(3): 734–742. DOI: 10.1177/036354651-7701911.

Hurni Y, Rosa V, De Gonzalez JG, Men-doza-Sagaon M, Hamitaga F, Pellanda G. (2017). Pediatric posterior cruciate ligament avulsion fracture of the tibial insertion: Case Report and Review of the Literature. The Surg Jour. 3(3): e134. DOI: 10.1055/S-0037-1605364

Joshi S, Bhatia C, Gondane A, Rai A, Singh S, Gupta S (2017). Open reduction and internal fixation of isolated posterior cruciate ligament avulsion fractures: Clinical and functional outcome. Knee Surg & Rel Res. 29(3): 210–216. DOI: 10.5792/ksrr.17.022.

Katsman A, Strauss EJ, Campbell KA, Alaia MJ (2018). Posterior cruciate ligament avulsion fractures. Cur Rev in Musc Med. 11(3): 503. DOI: 10.1007/S12178-018-9491-2.

Nagashree V, Kambhampati SBS, Kunda S (2022). Avulsion of posterior cruciate ligament (PCL) in an adolescent with open tibial physis fixed with fiber-wires. Jour of Orth Rep. 1(1): 63–66. DOI: 10.1016/J.JOREP.2022.03.019

Phatama KY, Lesmana A, Cendikiawan F, Pradana AS, Mustamsir E, Hidayat M (2021). Unusual combination of pos-terior cruciate ligament tibial avulsion fracture and Segond fracture: A case report. Int Jour of Sur Case Rep. 86: 106380. DOI: 10.1016/J.IJSCR.2021.106380.

White EA, Patel DB, Matcuk GR, Forrester DM, Lundquist RB, Hatch GFR (2013). Cruciate ligament avulsion fractures: Anatomy, biomechanics, injury patterns, and approach to management. Emer Rad. 20(5): 429–440. DOI: 10.1007/s10140-013-1121-0.

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Published

2024-01-10

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