The addition of an avulsion fracture to an intra-articular soft tissue injury may indicate more significant instability than what is normally seen. įracture patterns, along with information such as patient age, can provide information for the injury mechanism as well as predict stability and predict associated soft tissue injuries. These injuries are important to recognize because they are frequently associated with other concomitant soft tissue, or osteocartilaginous injuries, or can indicate joint instability. Some types of avulsion fractures are quite common, and many others are very rare, but may remain clinically significant. Some areas of the body incorporate many individual joints in very close approximation like the wrist and hand while other joints like the knee, have multiple articulating surfaces within the joint itself, each with a complex, sometimes overlapping network of muscles, tendons, ligaments, meniscus and capsular attachments that all play a role in both function and stability of the joint. Īvulsion fractures often happen near joints due to large numbers of supporting osseous, tendinous, and capsuloligamentous structures in a relatively close anatomic space, or at apophyseal myotendinous attachment sites. Although size is a consideration, and often significant, size does not necessarily correlate with clinical significance in every injury. Clinical significance can be benign or extremely clinically relevant. They can represent small or large fractures. Īvulsion fractures, as a topic, is very broad, with diverse mechanisms, clinical scenarios, presentations, and a wide range of appropriate management depending on where it occurs. Soft tissue attachments to bone can include ligaments, tendons, sub tendon sheaths, joint capsule, labrum, retinaculum, meniscus, or syndesmosis. Less commonly, avulsion fractures can also be a complication from a surgical procedure, or the result of a pathologic condition such as a genetic defect, infection, or neoplasm. Avulsion fractures can occur in any area where soft tissue is attached to bone. The failure of bone most commonly results from an acute event with the application of usually sudden, tensile force to the bone through the soft tissue, or when chronic repetitive avulsive stresses lead to a piece of bone being pulled away by the soft tissue. Review the importance of improving care coordination among interprofessional team members to improve outcomes for patients who sustain avulsion fractures.Īn avulsion fracture is a failure of bone in which a bone fragment is pulled away from its main body by soft tissue that is attached to it.Outline the management options available for avulsion fractures.Describe the importance of recognizing concomitant soft tissue injuries that occur with avulsion fractures.Identify the etiology of avulsion fractures in both the adult and adolescent patient populations.This activity reviews the role of the interprofessional team in the diagnosis and management of avulsion fractures.
They can be difficult to recognize or appear insignificant, yet early diagnosis is key to directing appropriate work-up, referral, and treatment. They often present with distinct mechanisms of injury as well as concomitant soft tissue or intra-articular injuries. The failure of bone most commonly results from an acute event with the application of usually sudden, tensile force to the bone through the soft tissue, or when chronic repetitive avulsive stresses lead to a piece of bone being pulled away by the soft tissue. Avulsion fractures can happen anywhere in the body where soft tissue attaches to the bone.
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