Anterior cruciate ligament avulsion fracture
Last revised by Andrea Molinari ◉ on 4 Dec 2022
Citation, DOI, disclosures and article data
Citation:
Weerakkody Y, Molinari A, El-Feky M, et al. Anterior cruciate ligament avulsion fracture. Reference article, Radiopaedia.org (Accessed on 04 Jun 2023) https://doi.org/10.53347/rID-37764
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rID:
37764
Article created:
22 Jun 2015, Yuranga Weerakkody ◉
Disclosures:
At the time the article was created Yuranga Weerakkody had no recorded disclosures.
View Yuranga Weerakkody's current disclosuresLast revised:
4 Dec 2022, Andrea Molinari ◉
Disclosures:
At the time the article was last revised Andrea Molinari had no recorded disclosures.
View Andrea Molinari's current disclosuresRevisions:
16 times, by 9 contributors - see full revision history and disclosures
Systems:
Sections:
Synonyms:
- 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
Anterior cruciate ligament (ACL) avulsion fracture or tibial eminence avulsion fracture is a type of avulsion fracture of the knee. This typically involves separation of the tibial attachment of the ACL to variable degrees. Separation at the femoral attachment is rare 5.
On this page:
Epidemiology
It is more common in children than adults. It has been hypothesized that this may be due to the relative weakness of incompletely ossified bone relative to ligamentous fibers 7, or relatively increased elasticity of ligament in children 8.
Pathology
Mechanism
They are usually caused by forceful hyperextension of the knee or by a direct blow over distal end of 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.
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
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