(Fig 3-A.22) Meniscofemoral Ligament Avulsion Fracture

https://youtu.be/AQG4wxLAKlM

https://youtu.be/GSIg93UH3Oc

 

📌Deep MCL Avulsion Injury: Symptoms and Types

✅ Symptoms:

• Isolated meniscofemoral ligament tear: Chronic knee pain (no instability)
• Meniscotibial ligament tear: Knee instability, medial meniscus extrusion
• May mimic meniscal tear symptoms

✅ Injury Types:

1️⃣ Meniscofemoral Ligament Injuries

• Rare avulsion fractures in adults
• More prone to sprains/tears due to longer, thinner structure

2️⃣ Meniscotibial Ligament Injuries

• More common avulsion fractures 
• Thicker, shorter ligament more likely to avulse bone at attachment site
• Known as "reverse Segond fracture" if tibial avulsion

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🧐 Note: Pediatric MCL avulsion fractures

In the immature skeleton, the proximal attachment of the superficial MCL and the attachment sites of the deep MCL on both the femur and tibia are located at the epiphyseal regions.

→  Pediatric MCL avulsion fractures can be entirely non-osseous, so radiographically occult.
→ MRI may be necessary to identify and characterize these avulsion injuries involving the epiphyseal regions.

 

✅ Current Case:

• Complete proximal superficial MCL tear
• Femoral avulsion fracture of meniscofemoral ligament (deep MCL)
• Meniscofemoral ligament thickened and distally retracted
• Better visualized on CT/radiography than MRI
• If meniscotibial avulsion would be termed "reverse Segond fracture"

 

Pediatr Radiol. 2021 Aug;51(9):1705-1713

 

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