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1Principles

Injury types

Avulsion fractures can result from mild to moderate injury to the knee. Twisting injuries to the knee may result in major ligament disruptions of the medial collateral, or anterior or posterior cruciate ligaments (PCL). It is most commonly the medial collateral (MCL) and the anterior cruciate ligament (ACL) that are injured. Patients with an anterior cruciate ligament disruption will sometimes report a popping sensation from the knee at the time of injury. A rapid early hemarthrosis will develop with an anterior cruciate ligament injury. Anterior cruciate ligament injuries most commonly occur in young patients, who partake in sporting activities. Small avulsion fractures may represent markers or significant injuries to the knee, such as multiligamentous knee dislocation. MRI can detect significant ligament damage. Consultation and advice from specialist knee reconstructive surgeons may need to sought.

Fixation of these important ligamentous avulsion fractures is essential to knee joint stability, especially in association with intra-substance ligament injuries. Healing in displacement results in joint stiffness and laxity.