Posterior cruciate ligament avulsion fracture

Case contributed by Chris Newman
Diagnosis certain

Presentation

MVA. Knee pain. ? Fracture

Patient Data

Age: 35 years
Gender: Male

Minimally-displaced fracture of the posterior aspect of the tibial spine. Large joint effusion.

Comminuted PCL avulsion fracture located at posterior aspect of the tibial spine/tibial plateau. A few small comminuted fragments are identified in addition to the large fracture fragment.

PCL avulsion fracture with large fracture fragment. The PCL is intact, but redundant. The posterior root of both the medial and lateral meniscus also attaches onto the fracture fragment. The meniscal roots themselves are intact.

Other findings:

  • Posterior meniscocapsular strain
  • Mild lateral meniscus extrusion
  • Semimembranosis tendon sprain
  • Large hemarthrosis

Case Discussion

PCL avulsion injuries are common in MVAs and occur when the knee hits the dashboard in a flexed position and forcefully translates the tibia posteriorly.

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