Isolated Femoral LCL Avulsion Fracture in the Adult Knee: Two Patient Cases and Literature Review.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_522ECF2B343B
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Isolated Femoral LCL Avulsion Fracture in the Adult Knee: Two Patient Cases and Literature Review.
Journal
Case reports in orthopedics
Author(s)
Dietrich G., Maeder B., Nyland J., Maeder Y., Akiki A., Martin R.
ISSN
2090-6749 (Print)
ISSN-L
2090-6757
Publication state
Published
Issued date
2022
Peer-reviewed
Oui
Editor
Di Cesare Paul E.
Volume
2022
Pages
6507577
Language
english
Notes
Publication types: Case Reports
Publication Status: epublish
Abstract
Avulsion injuries of the LCL most commonly occur at the fibular insertion. Femoral LCL avulsion injuries have only been previously described in pediatric patients or as multiligament knee injury components among adults. This case series with comprehensive literature review describes for the first time 2 cases of isolated LCL femoral avulsion fractures in adults including conservative treatment outcomes. Both patients sustained a strong varus stress mechanism to their right knee, following sport injury or road traffic accident. For both patients, a complete radiographic evaluation including X-rays, MRI, and CT scan confirmed no other associated knee lesions. The femoral LCL avulsion fractures that were observed were minimally displaced and noncomminuted. Furthermore, imagery suggested preserved integrity at the superior lateral genicular artery, adjacent articular capsule, and IT band. Based on clinical and imaging evaluations, the decision was made to follow conservative treatment. By 10 weeks postinjury, both patients were asymptomatic with early radiological fracture healing evidence. Comparative varus stress radiographs at 20° knee flexion revealed no side-to-side differences and clinical exam showed no posterolateral rotatory instability. The second patient case presented with mild femoral LCL attachment calcification on follow-up CT-scan. Following a detailed analysis of anatomic injury characteristics, we suggest that patients with isolated femoral LCL avulsion fractures have low secondary displacement risk provided SLGA, articular capsule, and IT band integrity are present. In contrast to high-grade ligamentous and distal avulsion LCL injuries, we recommend conservative treatment for patients who sustain these lesions.
Keywords
Insect Science, Ecology, Ecology, Evolution, Behavior and Systematics
Pubmed
Open Access
Yes
Create date
01/05/2022 14:33
Last modification date
14/08/2024 6:17
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