Tibial spine fracture with anterior cruciate ligament avulsion: type 4

Case contributed by Dr Jeremy Jones


Football injury with hyperextension and direct trauma. Unable to weightbear.

Patient Data

Age: 14
Gender: Male

The lateral radiograph clearly demonstrates a fracture of the tibial spine with the fracture fragment in the joint space.

The large tibial spine avulsion is clearly demonstrated on the CT. There is a separate incidental fibrous cortical defect.

Case Discussion

The ACL has been avulsed from its tibial insertion with multiple fragments of bone. ACL avulsion injuries can be classified into four different types - this is a type 4 injury. In addition, there is a fibrous cortical defect on the medial cortex of the proximal tibia.

PlayAdd to Share

Case information

rID: 27372
Published: 31st Jan 2014
Last edited: 16th Jul 2018
Tag: knee
Inclusion in quiz mode: Included

Updating… Please wait.

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.