Tibial eminence avulsion fracture - Meyers and McKeever type 3b

Case contributed by Yaïr Glick
Diagnosis certain

Presentation

Fell off his scooter and injured his right knee

Patient Data

Age: 14 years

Fractured right tibial eminence, seen on frontal view.

Right anterior cruciate ligament (ACL) avulsion fracture involving most of the tibial eminence - Meyers and McKeever type 3b. Lipohemarthrosis in the suprapatellar bursa.
Fibrous cortical defect (FCD) in the posteromedial cortex of the right distal femoral metaphysis, another tiny FCD in the posteromedial cortex of the left distal femoral metaphysis.

Case Discussion

Hurt his right leg falling off his scooter, complains of leg pain, and has difficulty stepping on the ipsilateral foot. On physical examination, the right knee is swollen and diffusely painful. No evidence of effusion or skin abrasion. Full active straightening elicits pain, limited knee flexion. Coarse strength preserved, no neurovascular compromise.

Tibial eminence fracture on plain film. CT knees verified ACL avulsion fracture. It also showed an incidental fibrous cortical defect in each distal femoral metaphysis.

The leg was placed in a plaster cast.

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