In this X-ray, there is a tiny avulsion fracture where the anterolateral ligament has pulled off from the tibia.
What is the importance of an avulsion fracture?"
The presence of an avulsion fracture on X-ray indicates that there has been traction damage to soft tissues, usually from a ligament being pulled away from the bone - but the tiny bony fragment may be easily missed on X-ray.
Common avulsions include tibial tubercle avulsion and tibial spine avulsion. Avulsion of the anterolateral ligament is important not to miss.
"....The Segond fracture is commonly regarded as pathognomonic for significant intra-articular pathology such as an anterior cruciate ligament (ACL) tear. There is worsened rotatory instability in patients with concomitant ACL tear and Segond fracture...."
"Anterior cruciate ligament (ACL) avulsion fractures....result in significant disability if left untreated....[and] are caused by forceful hyperextension of the knee or by a direct blow over distal end of femur with the knee flexed."
"PCL [posterior cruciate ligament] avulsion fractures are rare injuries that can lead to significant morbidity when not recognized and treated properly"
Forum discussions
- Mislead diagnostic - Patients discussing MRI scans and avulsion fractures.