Presentation
Pushbike vs car, Right knee swelling and pain.
Patient Data
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Minimally displaced intra-articular fracture of the posterior tibia is associated with a large hemarthrosis. Fracture is at the expected site of the tibial insertion of the posterior cruciate ligament.
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Comminuted mildly displaced fracture of the central posterior tibial plateau. Large lipo-hemarthrosis.
The posterior cruciate ligament inserted onto the fracture fragments (just visible on the sagittal bone windows.
In conclusion there is a comminuted avulsion fracture of the central posterior tibial plateau. MRI would better show the soft tissue structures.
Case Discussion
MRI was not performed in this case since there was no clinical concern regarding the other ligaments or menisci.
The fragment attached to the PCL was screwed to the tibia intraperatively and the patient placed in a hinged knee brace with followup radiographs until the fracture had healed.