Anterior cruciate ligament avulsion fracture
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At the time the article was created Yuranga Weerakkody had no recorded disclosures.
View Yuranga Weerakkody's current disclosuresAt the time the article was last revised Tariq Walizai had no financial relationships to ineligible companies to disclose.
View Tariq Walizai's current disclosures- Anterior cruciate ligament bony avulsion fracture
- ACL avulsion fracture
- Bony ACL avulsion
- ACL bony avulsion
- ACL bony avulsion fracture
- Tibial eminence avulsion fractures
- Tibial eminence avulsion fracture
- Anterior cruciate ligament avulsion-fracture
- Tibial eminence fractures
Anterior cruciate ligament (ACL) avulsion fractures, also known as tibial eminence avulsion fractures, are a type of knee avulsion fracture. They typically involve separation of the tibial attachment of the ACL to variable degrees, although separation at the femoral attachment is rare 5.
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Epidemiology
This injury is more common in children aged 8-14 years than in adults. It has been hypothesized that this may be due to the relative weakness of incompletely ossified bone relative to ligamentous fibers 7 or the relatively increased elasticity of ligaments in children 8.
Pathology
Mechanism
They are usually caused by forceful hyperextension of the knee or by a direct blow over the distal end of the femur with the knee flexed.
Classification
Radiographic features
Plain radiograph
Depending on the type, a tibial avulsion is typically seen as a fracture fragment in variable orientation involving the tibial eminence. There may be anterior translation of the femur on the tibia on the lateral view.
Treatment and prognosis
Non-displaced fractures can be treated non-operatively in near or full extension immobilization 9. Displaced fractures need to be reduced with various surgical approaches, some include internal fixation 9.
References
- 1. Sundararajan S, Rajasekaran S, Bernard S. Displaced Anterior Cruciate Ligament Avulsion Fractures: Arthroscopic Staple Fixation. Indian J Orthop. 2011;45(4):324-9. doi:10.4103/0019-5413.82336 - Pubmed
- 2. Huang T, Hsu K, Cheng C et al. Arthroscopic Suture Fixation of Tibial Eminence Avulsion Fractures. Arthroscopy. 2008;24(11):1232-8. doi:10.1016/j.arthro.2008.07.008 - Pubmed
- 3. Gottsegen C, Eyer B, White E, Learch T, Forrester D. Avulsion Fractures of the Knee: Imaging Findings and Clinical Significance. Radiographics. 2008;28(6):1755-70. doi:10.1148/rg.286085503 - Pubmed
- 4. Salehoun R & Pardisnia N. Rehabilitation of Tibial Eminence Fracture. J Can Chiropr Assoc. 2007;51(2):99-105. PMC1924663 - Pubmed
- 5. Pai S, Aslam Pervez N, Radcliffe G. Osteochondral Avulsion Fracture of the Femoral Origin of the Anterior Cruciate Ligament in an 11-Year-Old Child. Case Rep Med. 2012;2012:506798. doi:10.1155/2012/506798 - Pubmed
- 6. Zaricznyj B. Avulsion Fracture of the Tibial Eminence: Treatment by Open Reduction and Pinning. J Bone Joint Surg Am. 1977;59(8):1111-4. - Pubmed
- 7. Wiley J & Baxter M. Tibial Spine Fractures in Children. Clin Orthop Relat Res. 1990;(255):54-60. - Pubmed
- 8. Noyes F, DeLucas J, Torvik P. Biomechanics of Anterior Cruciate Ligament Failure: An Analysis of Strain-Rate Sensitivity and Mechanisms of Failure in Primates. J Bone Joint Surg Am. 1974;56(2):236-53. - Pubmed
- 9. Si Heng Sharon T, Fadzil K, Andrew Kean Seng L, James Hoipo H. Surgical Management of Tibial Eminence Avulsion Fractures: A Systematic Review and Meta-Analysis. Arch Orthop Trauma Surg. 2024;144(7):3153-9. doi:10.1007/s00402-024-05318-1 - Pubmed
Incoming Links
- Anterior cruciate ligament avulsion fracture
- Anterior cruciate ligament (ACL) avulsion fracture
- Tibial spine fracture
- Segond fracture
- Anterior cruciate ligament avulsion fracture
- Avulsion fractures of anterior and posterior cruciate ligaments
- Avulsion fractures of the knee
- Tibial eminence avulsion fracture - Meyers and McKeever type 3b
- Segond and tibial spine avulsion fractures
- Concomitant complete tear of MCL and ACL avulsion fracture in right knee joint
- Anterior cruciate ligament avulsion fracture
- Tibial intercondylar eminence fracture
- Femoral-sided ACL avulsion fracture
- Avulsion fracture of the tibial eminence
- ACL avulsion fracture
- Anterior cruciate ligament avulsion injury
- ACL avulsion and Segond fracture
- ACL avulsion fracture
- Tibial spine fracture
- Avulsion tibial eminence - ACL origin
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