Avulsion fracture at the femoral attachment of the anterior cruciate ligament after intercondylar eminence fracture of the tibia

Ligament injury occurs less frequently than does bony injury in children because ligament strength in children is greater than the strength of the bone and the growth plate.(2) Avulsion fracture involving the tibial attachment of the ACL in children is a well-recognized, although somewhat uncommon, injury. (2,4,9,10) Avulsion fracture at the femoral attachment of the ACL, however, is rare. Only three cases have been reported in the English literature. (3,13,16) In these three cases the patients had not sustained previous fractures in the knee joint before the avulsion fracture. We report an unusual case of consecutive avulsion fractures involving the ACL in which a tibial attachment avulsion fracture was followed by a femoral attachment avulsion fracture.