Clinical efficacy of suture bridge versus hollow screw fixation for PCL tibial avulsion fractures: a comparative study.

Abstract

Objective: To evaluate and compare the clinical outcomes of the suture bridge technique and hollow screw fixation in treating posterior cruciate ligament (PCL) tibial avulsion fractures.

Methods: A retrospective analysis was conducted on 40 patients treated between January 2013 and December 2023. Patients were divided into two groups: the suture bridge group (20 cases) and the hollow screw group (20 cases). Both groups underwent minimally invasive surgery with a small posteromedial arc incision. The suture bridge technique utilized high-strength sutures and suture anchors, while the hollow screw group employed 3.5 mm hollow screws. Postoperative outcomes were assessed using Lysholm, Tegner and International Knee Documentation Committee (IKDC) scores, with radiographic imaging performed at regular intervals to monitor fracture healing.

Results: Both groups showed significant improvements in Lysholm, Tegner and IKDC scores postoperatively (P < 0.05). The Tegner score in the suture bridge group was slightly higher than that in the hollow screw group (P = 0.038). The postoperative drainage volume in the suture bridge group was slightly higher than that in the hollow screw group (P = 0.011), with no significant differences in surgical time, intraoperative blood loss or joint mobility (P > 0.05). Most fractures healed within 3 to 6 months. In the suture bridge group, two cases of malunion were observed due to small bone fragment displacement. In the hollow screw group, two cases of screw head retraction and one case of bone fragment displacement were noted.

Conclusion: Both the suture bridge technique and hollow screw fixation are effective for treating PCL tibial avulsion fractures, each with unique advantages and potential complications. The suture bridge technique provides secure fixation, particularly for comminuted fractures, and is suitable for pediatric patients to avoid growth plate injury.

Clinical trial number: Not applicable.