Objective  To investigate the effectiveness and technical points of posterior open approach combined with suture bridge technique for the treatment of tibial insertion avulsion fractures of posterior cruciate ligament (PCL). Methods  A retrospective analysis was conducted on 21 patients with PCL tibial insertion avulsion fractures who underwent posterior open approach combined with suture bridge technique between July 2023 and July 2025. There were 14 males and 7 females, aged 11-68 years (mean, 48.3 years). Fracture displacement ranged from 3.9 to 13.7 mm, with an average of 7.9 mm. Preoperative Lysholm score was 46.1±3.9, International Knee Documentation Committee (IKDC) subjective score was 44.8±4.1, and posterior knee laxity was (4.1±0.5) mm. The time from injury to surgery ranged from 1 to 30 days, with an average of 9.4 days. The operation time and intraoperative blood loss were recorded. Knee function was assessed using Lysholm score and IKDC subjective score. Posterior knee laxity was measured bilaterally using a KT-2000 arthrometer, and the results were expressed as the side-to-side difference. Results  All surgeries were successfully completed. The operation time ranged from 40 to 130 minutes (mean, 80.2 minutes), and intraoperative blood loss ranged from 7 to 20 mL (mean, 10.4 mL). All incisions healed by first intention without early complication such as surgery-related infection or neurovascular injury. All 21 patients were followed up 12-20 months, with a mean of 18.3 months. Radiographic examination showed anatomical reduction and bony union in all fractures, with healing time ranging from 8 to 14 weeks (mean, 11.5 weeks). During follow-up, no reduction loss, implant loosening or breakage was observed. At last follow-up, the Lysholm score was 90.3±3.1, IKDC subjective score was 91.0±3.1, and posterior knee laxity was (1.6±0.4) mm, all showing significant differences compared with preoperative values (P<0.05). Conclusion The posterior open approach combined with suture bridge technique for PCL tibial insertion avulsion fractures offers the dual advantages of reliable reduction under direct vision and robust fixation with suture bridge, demonstrating safety and efficacy. It is particularly suitable for complex cases such as comminuted fractures, old fractures, or those complicated by posterior neurovascular injury.

Citation： ZHU Bowen, WANG Weijun, ZHANG Minghao, JIANG Qing. Posterior open approach combined with suture bridge technique for tibial insertion avulsion fractures of posterior cruciate ligament. Chinese Journal of Reparative and Reconstructive Surgery, 2026, 40(4): 557-562. doi: 10.7507/1002-1892.202511099 Copy

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