OSSEOUS FEMORAL AVULSION OF THE ACL ORIGIN, WITH AN OTHERWISE INTACT ACL – A CASE REPORT

Anterior cruciate ligament (ACL) avulsion fracture is commonly associated with knee injuries and its management is controversial ranging from conservative treatment to arthroscopic xation. (1) They occur due to sporting or high-velocity trauma. Tears of the anterior cruciate ligament supersede osseous avulsion in the adult demographic. In adults, ACL tears commonly occur in the mid-substance and less commonly avulses from its tibial attachment. Femoral avulsions of the ACL occur less frequently (2). Most of the cases reported in the clinical literature occurred in the skeletally immature patients because of relatively elastic connective tissue and correspondingly weaker bony structures (2). Avulsion fractures of the cruciate ligaments are important, as they can be identied on radiographs, allowing a specic diagnosis. The treatment of cruciate ligament avulsion fractures is different than the treatment of intrasubstance tears of the cruciate ligaments. These injuries can be treated conservatively or surgically with good outcomes. Recently arthroscopic xation of these injuries with various xation devices has become more frequent. Treatment largely depends on the type of fracture, particularly, the size, displacement, comminution, and orientation of the avulsed fracture fragment, in addition to the integrity of the attached cruciate ligament. (3)