Background: Posterior cruciate ligament (PCL) avulsion fractures are uncommon but potentially debilitating injuries, typically resulting from high-energy trauma. Surgical intervention is often required to restore knee stability and function. The traditional posterior approach poses risks to neurovascular structures and may involve significant soft tissue dissection. Objective: To evaluate the clinical and radiological outcomes of posterior cruciate ligament avulsion fracture fixation using a minimally invasive postero-medial approach. Methods: A prospective study was conducted on 20 patients with isolated PCL avulsion fractures treated surgically between February 2023 and March 2024 at the Pacific Institute of Medical Sciences, Udaipur, India. Fixation was performed using corticocancellous screws via a posteromedial approach. Clinical assessments were done using the Knee Society Score, and radiographic evaluations were conducted at multiple postoperative intervals. Results: All patients achieved stable fixation without any neurovascular complications. Postoperative assessments revealed excellent outcomes in 14 patients and good outcomes in 6. All patients demonstrated negative posterior drawer and reversed pivot shift tests, confirming restored posterior knee stability. Conclusion: The posteromedial approach provides a safe, effective, and less invasive method for fixing PCL avulsion fractures, preserving soft tissue integrity while achieving excellent clinical and radiological outcomes.

Posterior cruciate ligament, PCL avulsion fracture