Question

11 year-old boy presents with right knee pain and swelling after falling off of his bicycle. What's the diagnosis?

Answer

Answer: Fracture of the intercondylar eminence of the tibia; Meyers & McKeever Grade II (grading system described below)

 

Intercondylar Eminence Fracture

• Avulsion of the insertion of the ACL because the ligament stronger than incompletely ossified bone in children
• Incidence is 3 in 100,000 children
• Most common injury mechanism
  • Falls from a bicycle
  • Motor vehicle crash
• Meyers and McKeever’s classification system
  • I (non-displaced) - Generally treated non-operatively with long-leg casting
  • II (hinged fragment)  - Generally treated like Grade I
  • III (displaced) - Requires surgical fixation

 

 

Reference: Tudisco, C., et al Intercondylar eminence avulsion fracture in children: long-term follow-up of 14 cases at the end of skeletal growth, J Pediatr Orthop B 19:403–408 c 2010

References

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