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Objectives: To report clinical and functional outcomes following fixation of tibial posterior cruciate ligament (PCL) avulsion fractures through Burks and Schaffer's approach when combined with a rehabilitation programme, which emphasizes early range of motion. Design: Retrospective study Setting: Level 1 trauma centre, All India Institute of Medical Sciences (AIIMS), New Delhi Patients: From December 2006 to June 2009, 18 cases of PCL tibial avulsion injuries presented to our institution and underwent surgical intervention. Patients were followed up for 10 to 16 months (mean 12 months). Intervention: Fixation of tibial PCL avulsion fractures was with one or two 4-mm partially threaded cannulated screw and washer placed through a Burks and Schaffer's approach. Range of motion was begun on postoperative day 2. Main outcome measurements: Range of motion, clinical stability, radiographic appearance, each patient's overall health-related quality of life (using the musculoskeletal functional assessment tool) and gastrocnemius muscle strength were evaluated at final follow-up. Results: Union was achieved in all the cases, and all of them were having clinically stable knee at the time of last follow-up. The average musculoskeletal functional assessment score was 14. (Musculoskeletal functional assessment scores range from 0-100, with higher scores indicating poorer function.) [ABSTRACT FROM AUTHOR]

Falls are prevalent reasons for spinal cord injury (SCI). Postinjury fear of falling (FOF) can affect rehabilitation potential. We quantified FOF in 15 men with paraplegia (ambulatory with bilateral knee-ankle-foot orthoses [KAFOs] and elbow crutches) in correlation with their postural control at the center for long-term SCI rehabilitation of a tertiary-care teaching hospital. Our outcome measures comprised the American Spinal Injury Association Impairment Scale, the Modified Falls Efficacy Scale (MFES), postural sway measurements in the anteroposterior and mediolateral directions; and walking speed, cadence, and endurance. We assessed FOF with the MFES followed by measuring postural sway with a force platform. We measured gait parameters by asking the participant to ambulate on an indoor pathway. The mean postural sway was 314.13 +/-184.05 mm (mean +/- standard deviation) in the anteroposterior direction and 222.16 +/- 112.34 mm in the mediolateral direction. The MFES score was 41.29 +/- 12.77, which showed a statistically significant negative correlation with postural control. The self-perception of confidence as measured by MFES might not really represent the actual postural stability in individuals with low-level paraplegia. FOF can adversely affect the postural control of individuals with low-level paraplegia. Clinicians should consider FOF as an influential factor in postural control during rehabilitation. [ABSTRACT FROM AUTHOR]