Periosteal Avulsion of the Posterolateral Corner of the Knee in an Adolescent: An Unreported Case

Kovack, Thomas J.; Jacob, Paul; Tesner, R. J.; Papp, G. L.

doi:10.3928/01477447-20110826-22

Cited by 8 publications

(8 citation statements)

References 22 publications

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“…Most reports have been of isolated injury to the popliteus tendon, 8 while others report avulsion of both the LCL and popliteus. 3 The characteristic findings are an adolescent athlete with a history of varus-directed force, hemarthrosis, and osteochondral fragment of the distal lateral extra-articular femoral epiphysis visible on radiographs with associated injury to the popliteus and/or LCL on magnetic resonance imaging. 3 , 4 …”

Section: Discussionmentioning

confidence: 99%

“… 1 Methods of operative fixation vary from suture repair over a bony bridge, suture repair with suture anchors, and repair with screws and washers. 3 , 8 , 9 , 10 …”

Section: Discussionmentioning

confidence: 99%

“… 1 The bony fragment can include the femoral epiphyseal attachments of one or both of the popliteus and lateral collateral ligament (LCL) without involvement of the physis or metaphysis. 2 , 3 , 4 A purely ligamentous “peel-off” variant has been described in older patients. 5 , 6 Despite displacement of the origins of the major stabilizers of the lateral knee, clinical instability is not universally described.…”

mentioning

confidence: 99%

“… 7 Conversely, several techniques for operative management have been described in the setting of instability. 3 , 8 , 9 , 10 …”

mentioning

confidence: 99%

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Double-Row Suture Anchor Repair of Posterolateral Corner Avulsion Fractures

Gilmer

2017

Arthroscopy Techniques

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Posterolateral corner avulsion fractures are a rare variant of ligamentous knee injury primarily described in the skeletally immature population. Injury is often related to a direct varus moment placed on the knee during sporting activities. Various treatment strategies have been discussed ranging from nonoperative management, to excision of the bony fragment, to primary repair with screws or suture. The described technique is a means for achieving fixation of the bony avulsion using principles familiar to double-row transosseous equivalent rotator cuff repair. Proximal anchors are placed in the epiphysis, and sutures are passed in horizontal mattress fashion. Once tied, the limbs of these same sutures are then passed to more distal anchors. Remaining eyelet sutures can be used to manage peripheral tissue. The final repair provides anatomic reduction and compression of the fragment to its bony bed with minimal extracortical hardware prominence and no violation of the physis. Risks include potential for physeal injury or chondral damage to the lateral femoral condyle through aberrant anchor placement. Postoperative care includes toe-touch weight-bearing restrictions and range of motion restrictions of 0°-90° in a hinged brace for 6 weeks followed by gradual return to activity.

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Section: Discussionmentioning

confidence: 99%

“… 1 Methods of operative fixation vary from suture repair over a bony bridge, suture repair with suture anchors, and repair with screws and washers. 3 , 8 , 9 , 10 …”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

“… 7 Conversely, several techniques for operative management have been described in the setting of instability. 3 , 8 , 9 , 10 …”

mentioning

confidence: 99%

See 2 more Smart Citations

Double-Row Suture Anchor Repair of Posterolateral Corner Avulsion Fractures

Gilmer

2017

Arthroscopy Techniques

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“…To date, several radiological studies have investigated bone bruises and ACL injuries in pediatric patients. 20 , 21 , 23 Bordoni et al 3 reported a higher prevalence and similar distribution pattern of bone bruises and cartilage and meniscal lesions in pediatric patients with ACL injuries compared with adults. However, the distribution pattern was summarized as the location of bone bruises in all included patients instead of classifying the location of the bone bruise in each patient.…”

mentioning

confidence: 93%

Classification of Bone Bruises in Pediatric Patients With Anterior Cruciate Ligament Injuries

Wang

Zhang

et al. 2023

Orthopaedic Journal of Sports Medicine

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Background: Bone bruises are frequently found on magnetic resonance imaging (MRI) after an anterior cruciate ligament (ACL) tear in pediatric patients. Purpose: To establish a classification system for different bone bruise patterns to estimate the severity of a knee injury in pediatric patients with ACL tears. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A medical database was retrospectively reviewed to identify all cases of primary ACL tears in patients who were aged ≤17 years at the time of the injury and underwent MRI at our institution within 4 weeks of the injury between January 2011 and December 2020. A total of 188 patients were identified (67 male, 121 female; mean age, 15.1 ± 1.4 years). Bone bruises were classified according to their depth and location on MRI in the sagittal and coronal planes. Results: The new classification system identified 3 grades of depth: grade I, the bone bruise was located within the epiphysis but did not reach the epiphyseal plate (n = 54 [35.3%]); grade II, the bone bruise was within the epiphysis that reached the epiphyseal plate (n = 55 [35.9%]); and grade III, the bone bruise was in both the epiphysis and metaphysis (n = 44 [28.8%]). The bone bruise location was classified into 4 types: type a, the deepest bone bruise area was in the lateral tibial plateau (n = 66 [43.1%]); type b, the deepest bone bruise area was in the lateral femoral condyle, commonly occurring in the lateral one-third to two-thirds of the lateral femoral condyle (n = 22 [14.4%]); type c, the bone bruise area had a similar depth in both the lateral femoral condyle and lateral tibial plateau (n = 54 [35.3%]); and type d, the bone bruise area was in the lateral tibial plateau and lateral femoral condyle and extended to the fibular head (n = 11 [7.2%]). The prevalence of collateral ligament injuries increased from grade I to III. All patients with grade III type c bone bruises had meniscal lesions. Conclusion: This new classification system provides a basis for estimating associated lesions of the knee before surgery.

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Surgical management of isolated popliteus tendon injuries in paediatric patients

Liu

Rebolledo

Warren

et al. 2016

Knee Surg Sports Traumatol Arthrosc

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Isolated popliteus avulsion injuries are a rare occurrence, especially in the skeletally immature population. Two cases of isolated popliteus tendon avulsion injuries in paediatric patients were identified and successfully managed with suture anchor reattachment of the avulsed fragment in the anatomic position. The objective of this case report is to raise awareness of orthopaedic surgeons to the rarely encountered isolated popliteus tendon injury that can occur in paediatric patients. Level of evidence Expert opinion, Level V.

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Periosteal Avulsion of the Posterolateral Corner of the Knee in an Adolescent: An Unreported Case

Cited by 8 publications

References 22 publications

Double-Row Suture Anchor Repair of Posterolateral Corner Avulsion Fractures

Double-Row Suture Anchor Repair of Posterolateral Corner Avulsion Fractures

Classification of Bone Bruises in Pediatric Patients With Anterior Cruciate Ligament Injuries

Surgical management of isolated popliteus tendon injuries in paediatric patients

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