Emergency Radiology

, Volume 20, Issue 5, pp 429–440 | Cite as

Cruciate ligament avulsion fractures: Anatomy, biomechanics, injury patterns, and approach to management

  • Eric A. WhiteEmail author
  • Dakshesh B. Patel
  • George R. Matcuk
  • Deborah M. Forrester
  • Ryan B. Lundquist
  • George F. Rick HatchIII
  • C. Thomas Vangsness
  • Christopher J. Gottsegen
Review Article


Injury to the ACL or PCL of the knee most commonly involves a tear of the collagenous fibers of the ligament. Less frequently, a cruciate ligament injury involves an avulsion fracture at the origin or insertion of the ligament, usually from the insertion site on the tibial surface. Avulsion fractures of the cruciate ligaments are important, as they can be identified on radiographs, allowing a specific diagnosis. Although more common in children, when they occur in adults, they are more commonly associated with other injuries. 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 fixation of these injuries with various fixation 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. This review article covers the anatomy and biomechanics of the cruciate ligaments, their injury patterns, and approach to management.


Anterior cruciate ligament avulsion fracture Posterior cruciate ligament avulsion fracture Tibial spine fracture Intercondylar eminence fracture 



We acknowledge Matt Skalski for his artistic renderings of the mechanisms of injury and different types of cruciate ligament injuries.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Am Soc Emergency Radiol 2013

Authors and Affiliations

  • Eric A. White
    • 1
    Email author
  • Dakshesh B. Patel
    • 1
  • George R. Matcuk
    • 1
  • Deborah M. Forrester
    • 1
  • Ryan B. Lundquist
    • 1
  • George F. Rick HatchIII
    • 1
  • C. Thomas Vangsness
    • 1
  • Christopher J. Gottsegen
    • 1
  1. 1.Department of RadiologyLos AngelesUSA

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