Abstract:[Objective] To introduce the surgical technique and preliminary clinical results of self-developed guide posterior-anteriorto reduce and fix posterior cruciate ligament (PCL) avulsion tibial fracture. [Methods] From June 2020 to June 2022, 16 patients receivedthe self-developed guide posterior-anterior to reduce and fix PCL avulsion tibial fracture. After arthroscopic examination and debridement,the posterior medial compartment was entered anterior-posterior between the PCL and the medial femoral condyle to establish the postero-medial portals. Then the self-developed guide was placed, with the tip located at the lateral margin of the tibial tubercle, while a sleeve in-serted through the posteromedial portal aiming below the PCL fracture fragment to create tibial tunnel from the back to the front. The suturehook was used to introduce high-strength suture bundles through the PCL parenchyma, and the suture bundles were led out by PDS suturethrough the bone tunnel. Pulling out the suture bundles to reduce fracture, and fasten the sutures over button plate by tying to finish the sus-pension fixation. [Results] All the 16 patients were operated successfully without vascular or nerve damage, and were followed up for (9.7±2.8) months. Compared with those preoperatively, the IKDC score [(51.3±5.6) vs (91.4±3.1), P＜0.001] and Lysholm score [(46.3±3.4) vs(89.7±3.3), P＜0.001] significantly improved at the last follow-up. All the patients got fractures healed well, with stable knee and good flex-ionextension range of motion. [Conclusion] This self-developed guide used for reduction and fixation of PCL tibial avulsion fracture fromthe back to the front has advantages of accurate tunnel establishment, convenient and simple operation manipulation, and high surgical safe-ty.