Isolated Femoral LCL Avulsion Fracture in the Adult Knee: Two Patient Cases and Literature Review
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 ti...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Case Reports in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2022/6507577 |
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| author | Gilles Dietrich Benoît Maeder John Nyland Yaël Maeder Alain Akiki Robin Martin |
| author_facet | Gilles Dietrich Benoît Maeder John Nyland Yaël Maeder Alain Akiki Robin Martin |
| author_sort | Gilles Dietrich |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-adf564e1934e4da1b5a0dbde83f39ef5 |
| institution | OA Journals |
| issn | 2090-6757 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Orthopedics |
| spelling | doaj-art-adf564e1934e4da1b5a0dbde83f39ef52025-08-20T02:20:49ZengWileyCase Reports in Orthopedics2090-67572022-01-01202210.1155/2022/6507577Isolated Femoral LCL Avulsion Fracture in the Adult Knee: Two Patient Cases and Literature ReviewGilles Dietrich0Benoît Maeder1John Nyland2Yaël Maeder3Alain Akiki4Robin Martin5Orthopaedic DepartmentOrthopaedic DepartmentAthletic Training ProgramRadiology DepartmentOrthopaedic DepartmentOrthopaedic DepartmentAvulsion 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.http://dx.doi.org/10.1155/2022/6507577 |
| spellingShingle | Gilles Dietrich Benoît Maeder John Nyland Yaël Maeder Alain Akiki Robin Martin Isolated Femoral LCL Avulsion Fracture in the Adult Knee: Two Patient Cases and Literature Review Case Reports in Orthopedics |
| title | Isolated Femoral LCL Avulsion Fracture in the Adult Knee: Two Patient Cases and Literature Review |
| title_full | Isolated Femoral LCL Avulsion Fracture in the Adult Knee: Two Patient Cases and Literature Review |
| title_fullStr | Isolated Femoral LCL Avulsion Fracture in the Adult Knee: Two Patient Cases and Literature Review |
| title_full_unstemmed | Isolated Femoral LCL Avulsion Fracture in the Adult Knee: Two Patient Cases and Literature Review |
| title_short | Isolated Femoral LCL Avulsion Fracture in the Adult Knee: Two Patient Cases and Literature Review |
| title_sort | isolated femoral lcl avulsion fracture in the adult knee two patient cases and literature review |
| url | http://dx.doi.org/10.1155/2022/6507577 |
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