Journal of Musculoskeletal Trauma

Review Article

Treatment of avulsion fractures around the knee: Jeong-Hyun Koh, Hyung Keun Song, Won-Tae Cho, Seungyeob Sakong, Sumin Lim; J Musculoskelet Trauma 2025;38(2):63-73. Published online March 31, 2025; DOI: https://doi.org/10.12671/jmt.2025.00073

Avulsion fractures of the knee occur when tensile forces cause a bone fragment to separate at the site of soft tissue attachment. These injuries, which frequently affect adolescent athletes, can involve the cruciate and collateral ligaments, arcuate complex, iliotibial band, and patellar and quadriceps tendons. Radiographs aid in the initial diagnosis, while computed tomography and magnetic resonance imaging facilitate a comprehensive evaluation of injury severity and concomitant damage. Specific avulsion fracture types include: anterior cruciate ligament avulsions (tibial site, Meyers and McKeever classification), posterior cruciate ligament avulsions (tibial attachment, Griffith's classification), Segond fractures (anterolateral complex injury), iliotibial band avulsions, medial collateral ligament avulsions (reverse Segond, Stieda fractures), arcuate complex avulsions ("arcuate sign"), medial patellofemoral avulsions (patellar dislocations), and patellar/quadriceps tendon avulsions. The treatment depends on the fracture location, displacement, and associated injuries. Non-displaced fractures can be managed conservatively, while displaced fractures or those with instability require surgical reduction and fixation. Prompt recognition and appropriate intervention prevent complications such as deformity, nonunion, malunion, and residual instability. This review provides an overview of the pathogenesis, diagnosis, and management of knee avulsion fractures to guide clinical decision-making.

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Lateral marginal fractures of the patella and patellofemoral pain
Jae-Ang Sim, Chul-Ho Kim, Ji Wan Kim
Journal of Musculoskeletal Trauma.2025; 38(3): 152. CrossRef

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Original Article

Treatment of the Avulsion Injury of the Posterior Cruciate Ligament: Dong Wha Lee, Kyoo Seog Shin, Jong Soon Kim, Jin Jwan Seo; J Korean Soc Fract 1998;11(3):718-723. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.718

Abstract PDF

The posterior cruciate ligament (PCL) plays an integral role in stabilizing the knee joint as a main restraint to posterior displacement of the tibia. When the tibial insertion of the PCL is avulsed, the knee becomes unstable, so that rotational instability, meniscus injury and degenerative change may develop within several years. Therefore early repair is necessary. The purpose of this report is to evaluate the usefullness of the direct posterior approach to the avulsion site of PCL. We treated 8 isolated avulsion injury of the PCL from January 1995 to May 1997 through the way of using the Burks and Schaffer's simplified posterior approach. The results were as follows; 1. The stability was achieved with screw fixation. and the outcome was above good in 87.5% of cases. 2. The Burks and Schaffer's simplified posterior approach ws concerned as an useful one for the fixation of an avulsion fragment of PCL. 3. The patients returned daily living within 3 months after operation.

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Bilateral PCL Avulsion Fracture from Tibial Attatchment Site in a 16-years-old Male: A Case Report
Hee-Gon Park
Journal of the Korean Fracture Society.2009; 22(3): 189. CrossRef

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