Posterior Cruciate Ligament Avulsion with Posterior Tibial Rim Fracture: A Case Report

INTRODUCTION: Posterior cruciate ligament (PCL) avulsion fractures are the most common type of isolated PCL injuries. Avulsion from the tibia is more common than femoral attachment. They can present as isolated tibial avulsion or as a component of posterior tibial rim fractures. The size, geometry of the fragment, and associated ligamentous injury dictate the method of fixation. CASE REPORT: A 32-year-old patient presented with posterior rim tibial plateau fracture with PCL avulsion after a motor vehicle accident. We used Burke and Schaffer approach and fixed the ligamentous avulsion and rim fracture using high tensile sutures and knotless swivel lock anchors. CONCLUSION: PCL avulsions can present either as an isolated injury or as a part of a complex injury involving the anterior or posterior tibial rim. These complex injuries occur due to the hyperextension mechanism which results in either anterior tibial plateau compression fracture or posterior rim avulsion injuries. The treatment of such injuries requires addressing both ligamentous and bony components. The size, geometry of the fragment, and associated ligamentous injury dictate the method of fixation. We described the fixation of both ligamentous and rim avulsion using sutures and knotless anchors.