Cruciate ligament avulsion fractures

Griffith, James F.; Antonio, Gregory E.; Tong, Carol Y.; MING, C

doi:10.1016/s0749-8063(04)00592-4

Cited by 86 publications

(44 citation statements)

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“…There have been modifications to this system [30], yet treatment is typically dictated by the degree of displacement and differentiating between a type I, II, and III, which are all parts of the original classification scheme. Most incomplete eminence avulsions involved disruption of the anteromedial bundle [31].…”

Section: Diagnosismentioning

confidence: 99%

Pediatric ACL injuries: evaluation and management

Mall¹,

Paletta

2013

Curr Rev Musculoskelet Med

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The anterior cruciate ligament (ACL) is a stabilizing structure to both anterior translation of the tibia with respect to the femur as well as rotation of the knee joint. Children and adolescents are susceptible to these injuries, and there are some who believe the incidence of ACL injuries in this population is increasing due to year round single sport participation. Pediatric ACL injuries are typically seen in several forms: tibial avulsion fractures, partial ACL tears, and full thickness ligament tears. There were and still are some who feel that ACL injuries should be treated non-operatively in the pediatric and adolescent population; however, recent literature refutes this notion. Several factors must be considered during pediatric and adolescent ACL reconstruction, each of which will be examined in this manuscript, including: status of the physis, reconstruction technique, and graft source.

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Section: Diagnosismentioning

confidence: 99%

Pediatric ACL injuries: evaluation and management

Mall¹,

Paletta

2013

Curr Rev Musculoskelet Med

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“…In adults, injuries to the PCL typically are limited to the substance of the ligament [30]. Bony avulsions, in which an osteochondral fragment is detached from the PCL insertion site, also have been reported in adults [5,8,11,17,22,23,29,33,35,39]. In the pediatric population, PCL injuries are rare, likely as a result of the elasticity of the ligament [9,10,28].…”

Section: Introductionmentioning

confidence: 99%

Pediatric PCL Insufficiency from Tibial Insertion Osteochondral Avulsions

Pandya

Janik

Chan

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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Posterior cruciate ligament (PCL) insertion-site osteochondral avulsions in children, particularly from the tibia, are not commonly seen by orthopaedic surgeons. Because of the rarity of these injuries, careful attention to the specific physical examination and imaging findings seen with these injuries is necessary so that the proper diagnosis can be made. Osteochondral avulsions of the PCL can be missed on plain radiographs in skeletally immature patients, and therefore magnetic resonance imaging is necessary for proper diagnosis. With this knowledge, clinicians can formulate treatment plans which can return their patients to activities while avoiding potential morbidity resulting from missed diagnoses or improper treatment. We report two rare cases of PCL insufficiency stemming from tibial insertion osteochondral avulsions. Both patients underwent subsequent open reduction and internal fixation of the avulsion using two different fixation methods (bioabsorbable anchors versus cannulated screw and washer) and have returned to full sporting activities.

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“…Three of these patients were between 20 to 25 years old and one was 42; our patient was 22 years old. These patients seem to be relatively younger than patients with PCL avulsion fractures from the tibia [4,12]. Damage to the PCL by femoral avulsion has been reported in cadaveric specimens.…”

Section: Discussionmentioning

confidence: 88%

Case Report: Osteochondral Avulsion Fracture of the Posteromedial Bundle of the PCL in Knee Hyperflexion

Chen

Shi

Jiang

2012

Clinical Orthopaedics &Amp; Related Research

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Background Injury of the PCL of the knee in adults usually results in rupture rather than avulsion fracture and avulsions usually occur at the tibial insertion. Case Description We report an avulsion of the PCL with a femoral origin in a 22-year-old man who was injured by hyperflexion of the knee and was treated with arthroscopy. There were two parts in the partial osteochondral avulsion fracture of the PCL posteromedial (PM) bundle. One part was fixed with polydioxanone suture through drill holes and the other was removed. The fracture healed after 3 months and the knee was stable. At 11 months postoperatively the patient had returned to full-time work without pain or restrictions. The Lysholm II knee score was 95 points. Physical examination showed a negative posterior drawer sign. Literature Review We identified four other reported cases of PCL femoral origin avulsion fractures in adults. The subjects were 20 to 25 years old in four of five reports, including our patient. Three of the five patients had involvement of only the lateral cortex of the medial femoral condyle whereas two other patients including our patient, had an osteochondral fracture. The mechanism of PCL avulsion seems to be similar to that of a PCL rupture. Purposes and Clinical Relevance The hyperflexion injury may result in injury of the PM bundle of the PCL. Our case and one other in the literature suggest such avulsions need not involve the entire PCL.

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Cruciate ligament avulsion fractures

Abstract: Level III.

Cited by 86 publications

References 0 publications

Pediatric ACL injuries: evaluation and management

Pediatric ACL injuries: evaluation and management

Pediatric PCL Insufficiency from Tibial Insertion Osteochondral Avulsions

Case Report: Osteochondral Avulsion Fracture of the Posteromedial Bundle of the PCL in Knee Hyperflexion

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