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A 1 cm defect was created in the proximal medial cortex of 12 tibiae, cancellous bone was removed from the site, and the bones were fractured by loading in torsion. The fractures did not occur through the donor sites and the fracture patterns and loads to fracture were similar for the treated tibiae and their untreated mates. Cancellous bone was harvested from the proximal medial aspect of both tibiae in nine adult horses. The soft tissue wounds were monitored for more than 10 days in seven horses and healing of the osseous defects was evaluated radiographically at regular intervals to month 6 in two horses. The site provided convenient access with the horses in lateral or dorsal recumbency, the anatomic landmarks were reliable, and the surgical procedure was simple and short. Complications occurred in only three incisions.

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Case: A 30-year-old man was in a motorcycle accident resulting in an avulsion fracture of the tibial insertion of the posterior cruciate ligament (PCL). After 19 months of nonoperative treatment, the patient presented with a nonunion and symptoms of pain and instability. He was treated with an open repair with screw fixation through a posterior approach. Six months postoperatively, the patient returned to his work as a heavy laborer with full range of motion and no instability. Conclusion: PCL avulsion fracture nonunion results in symptoms of swelling, pain, and instability. These symptoms can be treated with screw fixation through a posterior approach.

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