title: Osteochondral avulsion fracture of the anterior cruciate ligament femoral origin in a 10-year-old child: a case report.
abstract: OBJECTIVE
  To describe the case of a 10-year-old football player who sustained a comminuted osteochondral avulsion fracture of the femoral origin of the anterior cruciate ligament (ACL) via a low-energy mechanism.
  
  
  BACKGROUND
  In children, both purely cartilaginous and osteochondral avulsion fractures have been described; most such ACL avulsions are from the tibial eminence. In the few previous case reports describing femoral osteochondral avulsion fractures, high-energy injury mechanisms were typically responsible and resulted in a single fracture fragment.
  
  
  METHODS
  Femoral osteochondral avulsion fracture at the ACL origin, femoral cartilaginous avulsion fracture at the ACL origin, midsubstance ACL tear, meniscal tear.
  
  
  METHODS
  Sutures and a button were used to repair the comminuted fragments. Postoperatively, a modified ACL reconstruction rehabilitation program was instituted.
  
  
  RESULTS
  Most injuries of this nature in youngsters are caused by a high-energy mechanism of injury, result in an osteochondral avulsion fracture of the tibial eminence, and involve a single fracture fragment.
  
  
  CONCLUSIONS
  Although they occur infrequently, ACL femoral avulsion fractures in children can result from a low-energy injury mechanism. Identifying the mechanism of injury, performing a thorough physical examination, and obtaining appropriate diagnostic studies will enable the correct treatment to be implemented, with the goal of safely returning the athlete to play.
authors.affiliation: Department of Orthopaedic Surgery, Marshall University, Huntington, WV 25701, USA. bengtson@marshall.edu
authors.forename: Hans
authors.initials: H
authors.lastname: Bengtson
authors.forename: Charles
authors.initials: C
authors.lastname: Giangarra
mesh_terms: D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy; D002648:Child; D005264:Femoral Fractures / Q000175:diagnosis* / Q000601:surgery; D005538:Football / Q000293:injuries*; D018460:Fractures, Comminuted / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D026741:Physical Therapy Modalities; D014057:Tomography, X-Ray Computed