Functional evaluation of fixation for PCL bony avulsion fractures using Burk and Schaffer's approach
International Journal of Orthopaedics Sciences
Posterior cruciate ligament (PCL) is the chief posterior stabilizer of the knee In literature, surgical indications for PCL injuries treatment remains debatable, but in PCL bony avulsion, surgical reinsertion of the avulsed fragment is a recommended procedure. Objective: This study was aimed to evaluate efficacy of Burk Schaffer's approach for fixation of tibial avulsion of PCL and to abstract the outcome of bony PCL avulsion fractures treated with cancellous screw fixation and their
... ns if any. Study Design: This was a prospective study conducted in 34 patients of isolated PCL avulsion fracture. Material and Methods: This study had 34 patients with age ranging from 28 to 50 yrs. It included 47.06% RTA, 26.47% sports trauma and 26.47% domestic injuries. All patients were evaluated by Xrays, MRI and CT preoperatively. Standard Burks Schaffer's approach was used in all cases. All patients were assessed radiologically for union, Tegner Lysholm Knee Scoring Scale and IKDC score and objective PDT manual examination for a period of 2 years after surgery were done. 67.65% achieved union in 12 weeks and 26.47% achieved union by 16 weeks, Delayed union was found in 5.88% beyond 16 weeks although none needed revision or reconstruction. Average pre-operative Lysholm score of 40 improved to 88 postoperatively. Average IKDC score preoperative was 33 which meliorated to 83 after treatment. Conclusion: Improvised approach by Burk and Schaffer is safer and easier than the classical one. Open reduction and fixation with cannulated screw is one of the excellent techniques for tibial avulsion of posterior cruciate ligament (PCL). The isolated PCL avulsion fractures treated with fixation have good Lysholm and IKDC scores, although objective laxity is present in significant number of cases without subjective disability. The isolated PCL injuries have good results if managed surgically.