Posterior cruciate ligament avulsion fracture

Case contributed by Luu Hanh

Presentation

Right knee swelling, and pain after a car accident.

Patient Data

Age: 35 years
Gender: Male

Displaced fracture of the posterior and medial articular surface of the upper tibia is seen with adjacent bone marrow edema. The fracture is at the expected site of the tibial insertion of the posterior cruciate ligament which is retracted.

Knee joint effusion.

The medial and lateral collateral, patellar, and anterior cruciate ligaments are normal. The quadriceps, semimembranosus tendons are normal. The menisci are normal. 

However, there is peritendinous and intramuscular fluid of the popliteus muscle and hemorrhage/fluid in the popliteal fossa between the popliteus, soleus and medial and lateral bellies of the gastrocnemius muscle.

Case Discussion

This case shows a posterior cruciate ligament avulsion fracture with a fracture at the central posterior tibial plateau. Joint effusion and signs of popliteal muscle injury indicative for a posterolateral corner injury.

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