Avulsion fractures of the posterior cruciate ligament of the knee. An experimental percutaneous rigid fixation technique under arthroscopic control.

A posterior cruciate ligament avulsion fracture (PCLAF) of the knee can be repaired through a large approach. A new technique based on internal fixation under arthroscopic control employed a posterolateral puncture. The fracture was reduced and the osseous fragment transfixed using a new forceps guide. The osseous fragment was stabilized through a tunnel drilled from the proximal anterior aspect of the tibial metaphysis by means of a cortical screw and an intraarticular nutwasher. The technique was made in eight undamaged normal fresh knees from distal ischemic amputated lower limbs. In six knees the technique was successful. In two knees the presence of hypertrophic synovium impeded a good visualization and the technique failed. In the hands of arthroscopic surgeons, this technique could be an effective alternative to arthrotomy in the treatment of PCLAF.