{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T19:09:06Z","timestamp":1788635346138,"version":"build-2803163510"},"reference-count":37,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016083","name":"Hebei Provincial Department of Human Resources and Social Security","doi-asserted-by":"publisher","award":["C20221122"],"award-info":[{"award-number":["C20221122"]}],"id":[{"id":"10.13039\/100016083","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Posterior cruciate ligament tibial avulsion fractures (PCLTAF) are characterized by complex injury mechanisms and treatment difficulties, with no standardized diagnostic or therapeutic guidelines currently available. This study aims to establish a classification\u2010based Bundle\u2010Weaving Zonal Fixation system to facilitate the precise treatment of PCLTAF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis was conducted on 100 patients with PCLTAF treated across multiple centers between 2016 and 2022. Based on fracture morphology, fragment characteristics, bone quality, and the extent of posterior ligamentous complex involvement, a novel classification system\u2014Xu\u2010Chen concise classification\u2014was developed using an inductive approach, categorizing PCLTAF into nine subtypes. Guided by this classification, four bundle\u2010weaving fixation techniques were designed, along with the development of a novel fixation system with tendon\u2010weaving holes. One representative case from each subtype (<jats:italic>n<\/jats:italic>\u2009=\u20099) underwent open reduction and subtype\u2010guided individualized fixation. Surgical time, intraoperative blood loss, complications, fracture healing, and functional outcomes (Lysholm and Tegner scores) were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>According to the Xu\u2010Chen concise classification, nine patients (six males and three females; mean age, 45\u2009years) underwent open reduction and individualized bundle\u2010weaving fixation. The average surgical duration was 77.2\u2009min (range, 60\u201395\u2009min), and the average intraoperative blood loss was 23.3\u2009mL (range, 15\u201340\u2009mL). The mean follow\u2010up period was 17.89\u2009months (range, 12\u201322\u2009months). The Lysholm knee score improved from 26.78 preoperatively to 97.22 postoperatively, while the Tegner activity score increased from 2.89 to 9.56. No complications such as deep vein thrombosis, joint stiffness, postoperative swelling, hematoma, infection, fixation failure, joint instability, or refracture were observed during follow\u2010up. Only one elderly patient experienced superficial wound necrosis, which healed with conservative wound care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The Xu\u2010Chen concise classification and its corresponding tendon\u2010bundled intraosseous fixation system offer a structured and standardized treatment pathway for PCLTAF. Preliminary results demonstrate promising outcomes in anatomical reduction, functional recovery, and surgical safety. This strategy shows clinical value in managing complex cases, such as comminuted fractures and osteoporotic bone.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.70135","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T09:35:43Z","timestamp":1756460143000},"page":"2943-2959","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Classification and Bundle\u2010Weaving Fixation for Posterior Cruciate Ligament Tibial Avulsion Fractures: Innovations and Applications of Key Techniques"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0257-6719","authenticated-orcid":false,"given":"Guangdong","family":"Chen","sequence":"first","affiliation":[{"name":"Academy of Medical Engineering and Translational Medicine Tianjin University  Tianjin China"},{"name":"Department of Neurosurgery UCSF Medical Center  San Francisco California USA"},{"name":"Department of Orthopedics Cangzhou Central Hospital  Cangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiguo","family":"Xu","sequence":"additional","affiliation":[{"name":"Tianjin Hospital, Tianjin University  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yibing","family":"Chen","sequence":"additional","affiliation":[{"name":"Queen Mary School, Jiangxi Medical College Nanchang University  Nanchang China"},{"name":"Department of Research Shurun Health Technology (Hebei) Co., Ltd.  Cangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Tianjin Hospital, Tianjin University  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengyue","family":"Yu","sequence":"additional","affiliation":[{"name":"Tianjin Hospital, Tianjin University  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000028273"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2014.02.005"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.885669"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546504270481"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-022-06926-3"},{"issue":"8","key":"e_1_2_11_7_1","first-page":"1677","article-title":"Fracture of the Intercondylar Eminence of the Tibia","volume":"52","author":"Meyers M. 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