A case of anterior cruciate ligament tear accompanied by avulsion fractures of tibial tuberosity and Gerdy's tubercle.
A 54-year-old man visited our clinic due to a painful swelling of his right knee. He had attempted a forceful kick by his right leg during a Sepak Takraw-like sports activity, only to fail to hit the ball. He felt a popping sense on the knee and collapsed, even without direct trauma. Imaging studies revealed a disruption of the anterior cruciate ligament (ACL), and separate avulsion fractures of the tibial tuberosity and Gerdy's tubercle. The fractures were stabilized by two cancellous screws, respectively. The intra-operative fluoroscopy demonstrated a manifest ACL insufficiency. A simultaneous reconstruction of the ligament was not performed. At 6 months after surgery, he had no difficulty in his activities of daily living. The involved knee joint was believed to have undergone a forceful pivot shift mechanism. Injuries to the ACL can be suspected from indirect signs on the radiologic images by a careful reconstitution of the injury mechanism and the associated lesions. Manifest osseous lesions on the plain radiographs can herald a major ligamentous injury and may be interpreted as an indirect sign of the ACL injury, which helps to establish a relevant management plan.
Yoo
Jae Ho
JH
Department of Orthopaedic Surgery, School of Medicine, Kyung Hee University, Center for Joint Diseases, Kyung Hee University East-West Neo Medical Center, 149 Sangil-dong, Gangdong-gu, Seoul 134-727, Republic of Korea. yoojaeho@hotmail.com
Kim
Kang-Il
KI
Yoon
Kyoung Ho
KH
D000203:Activities of Daily Living; D016118:Anterior Cruciate Ligament / Q000000981:diagnostic imaging; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction; D001863:Bone Screws; D005593:Fracture Fixation, Internal / Q000379:methods; D006801:Humans; D004204:Joint Dislocations / Q000150:complications / Q000473:pathology*; D007718:Knee Injuries / Q000150:complications / Q000473:pathology*; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D022125:Lacerations; D008297:Male; D008875:Middle Aged; D011859:Radiography; D020127:Recovery of Function; D013708:Tendon Injuries / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D013978:Tibial Fractures / Q000150:complications / Q000473:pathology* / Q000601:surgery