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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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