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<p>Avulsion fractures of the knee joint most commonly involve the insertion sites of the anterior (ACL) and posterior cruciate ligaments (PCL), the anterolateral complex (Segond fracture), the posterolateral ligament complex (PLC), as arcuate sign, the medial ligament complex (reverse Segond and Stieda fractures) and the extensor mechanism (patellar sleeve fractures). Tibial eminence fractures (ACL avulsions) are particularly frequent in children and adolescents, whereas tibial avulsions of the PCL are typically associated with high-energy trauma.</p><p>Initial diagnostics are primarily based on conventional radiography for detection of bony avulsion, while avulsion fractures often serve as important indirect markers of underlying ligamentous injuries. For instance, Segond fractures are considered pathognomonic for ACL rupture. Computed tomography (CT) and especially magnetic resonance imaging (MRI) are essential for detailed assessment of fragment size, displacement, intra-articular involvement and additionally to detect relevant accompanying injuries of the meniscus, cartilage and ligaments.</p><p>The treatment of knee avulsion fractures depends on the fracture location and extent of fragment displacement and functional impairment. Nondisplaced or minimally displaced fractures can usually be managed conservatively and typically with immobilization followed by structured rehabilitation. In contrast, displaced fractures, relevant instability or involvement of the extensor mechanism generally require surgical reduction and fixation to restore the function and joint stability; however, the available evidence particularly for rare entities is limited and a&#xa0;clear consensus on optimal management is often lacking.</p>

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Avulsionsfrakturen am Kniegelenk – eine Übersicht

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月6日

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  • Anton Ferdinand Schmidt,
  • Christoph Kittl,
  • Adrian Deichsel,
  • Larissa Eckl,
  • Riccardo D’Ambrosi,
  • Arasch Wafaisade,
  • Josina Maiti Münchgesang,
  • Jakob Ackermann,
  • Dominic T. Mathis,
  • Lukas Münch,
  • Gergo Merkely,
  • Lena Eggeling,
  • Andreas Martin Seitz,
  • Karl F. Schüttler,
  • Daniel Günther

摘要

Avulsion fractures of the knee joint most commonly involve the insertion sites of the anterior (ACL) and posterior cruciate ligaments (PCL), the anterolateral complex (Segond fracture), the posterolateral ligament complex (PLC), as arcuate sign, the medial ligament complex (reverse Segond and Stieda fractures) and the extensor mechanism (patellar sleeve fractures). Tibial eminence fractures (ACL avulsions) are particularly frequent in children and adolescents, whereas tibial avulsions of the PCL are typically associated with high-energy trauma.

Initial diagnostics are primarily based on conventional radiography for detection of bony avulsion, while avulsion fractures often serve as important indirect markers of underlying ligamentous injuries. For instance, Segond fractures are considered pathognomonic for ACL rupture. Computed tomography (CT) and especially magnetic resonance imaging (MRI) are essential for detailed assessment of fragment size, displacement, intra-articular involvement and additionally to detect relevant accompanying injuries of the meniscus, cartilage and ligaments.

The treatment of knee avulsion fractures depends on the fracture location and extent of fragment displacement and functional impairment. Nondisplaced or minimally displaced fractures can usually be managed conservatively and typically with immobilization followed by structured rehabilitation. In contrast, displaced fractures, relevant instability or involvement of the extensor mechanism generally require surgical reduction and fixation to restore the function and joint stability; however, the available evidence particularly for rare entities is limited and a clear consensus on optimal management is often lacking.