Hans Bengtson1, Charles Giangarra. 1. Department of Orthopaedic Surgery, Marshall University, Huntington, WV 25701, USA. bengtson@marshall.edu
Abstract
OBJECTIVE: To describe the case of a 10-year-old football player who sustained a comminuted osteochondral avulsion fracture of the femoral origin of the anterior cruciate ligament (ACL) via a low-energy mechanism. BACKGROUND: In children, both purely cartilaginous and osteochondral avulsion fractures have been described; most such ACL avulsions are from the tibial eminence. In the few previous case reports describing femoral osteochondral avulsion fractures, high-energy injury mechanisms were typically responsible and resulted in a single fracture fragment. DIFFERENTIAL DIAGNOSIS: Femoral osteochondral avulsion fracture at the ACL origin, femoral cartilaginous avulsion fracture at the ACL origin, midsubstance ACL tear, meniscal tear. TREATMENT: Sutures and a button were used to repair the comminuted fragments. Postoperatively, a modified ACL reconstruction rehabilitation program was instituted. UNIQUENESS: Most injuries of this nature in youngsters are caused by a high-energy mechanism of injury, result in an osteochondral avulsion fracture of the tibial eminence, and involve a single fracture fragment. CONCLUSIONS: Although they occur infrequently, ACL femoral avulsion fractures in children can result from a low-energy injury mechanism. Identifying the mechanism of injury, performing a thorough physical examination, and obtaining appropriate diagnostic studies will enable the correct treatment to be implemented, with the goal of safely returning the athlete to play.
OBJECTIVE: To describe the case of a 10-year-old football player who sustained a comminuted osteochondral avulsion fracture of the femoral origin of the anterior cruciate ligament (ACL) via a low-energy mechanism. BACKGROUND: In children, both purely cartilaginous and osteochondral avulsion fractures have been described; most such ACL avulsions are from the tibial eminence. In the few previous case reports describing femoral osteochondral avulsion fractures, high-energy injury mechanisms were typically responsible and resulted in a single fracture fragment. DIFFERENTIAL DIAGNOSIS: Femoral osteochondral avulsion fracture at the ACL origin, femoral cartilaginous avulsion fracture at the ACL origin, midsubstance ACL tear, meniscal tear. TREATMENT: Sutures and a button were used to repair the comminuted fragments. Postoperatively, a modified ACL reconstruction rehabilitation program was instituted. UNIQUENESS: Most injuries of this nature in youngsters are caused by a high-energy mechanism of injury, result in an osteochondral avulsion fracture of the tibial eminence, and involve a single fracture fragment. CONCLUSIONS: Although they occur infrequently, ACL femoral avulsion fractures in children can result from a low-energy injury mechanism. Identifying the mechanism of injury, performing a thorough physical examination, and obtaining appropriate diagnostic studies will enable the correct treatment to be implemented, with the goal of safely returning the athlete to play.
Authors: Ariel E Timkovich; Katie J Sikes; Kendra M Andrie; Maryam F Afzali; Joseph Sanford; Kimberli Fernandez; David Joseph Burnett; Emma Hurley; Tyler Daniel; Natalie J Serkova; Tammy Haut Donahue; Kelly S Santangelo Journal: Ann Biomed Eng Date: 2022-09-07 Impact factor: 4.219
Authors: Eric A White; Dakshesh B Patel; George R Matcuk; Deborah M Forrester; Ryan B Lundquist; George F Rick Hatch; C Thomas Vangsness; Christopher J Gottsegen Journal: Emerg Radiol Date: 2013-03-23