Phase I reconstruction
avulsion injury of the MCL, fracture, knee joints, avulsion injuries
In phase I, the collateral ligament was repaired first following detumescence (within 2 weeks of injury). For the avulsion injury of the MCL, the broken end was sutured and fixed at the femoral end or the tibial side using anchor nails, and the substantial fracture was directly sutured. For avulsion injuries of the LCL, the insertion point was fixed directly, and substantial injury or that combined with posterior lateral corner tear was turn-back repair using ipsilateral biceps femoris tendon. Turn-back repair was a surgical procedure in which a damaged or torn tendon was partially detached from its point of insertion, then folded back on itself and reattached. This technique was commonly employed to reinforce repaired tendons and ligaments, enhancing their strength and stability.All injured knee joints, including those underwent collateral ligament repair, required immobilization in the fully extended position with braces for 3 weeks before starting rehabilitation exercises. After 2 weeks of exercise, the exercise intensity was gradually increased until reaching the maximum tolerable or preoperative range of flexion and extension. Patients began with contact weight-bearing walking using crutches, followed by partial weight-bearing walking during the first 6 weeks, before transitioning to full weight-bearing walking.