Radiographic Review of Avulsion Fractures RadioGraphics Fundamentals
Radiographics. 2018 Sep-Oct;38(5):1496-1497. doi: 10.1148/rg.2018180064.
Narayanasamy S1, Krishna S1, Sathiadoss P1, Althobaity W1, Koujok K1, Sheikh AM1.
Avulsion fractures involve the attachment site of a soft-tissue structure (eg, a ligament or tendon) and occur when the structure is pulled off the bone. The pull of the soft-tissue structure causes tension, and if the tension is sufficiently higher than the tensile strength of the bone, avulsion occurs. The soft-tissue structure usually remains intact, but there is disruption to the underlying bone. These injuries are common in patients who participate in organized sports, especially in young athletes owing to the inherent weakness of their apophyses. In adults, these fractures usually occur in bones weakened by osteoporosis or metastatic disease.
Avulsion fractures are often subtle at conventional radiography, which is usually the first imaging examination performed for these injuries (Fig 1). CT and MRI may be needed to adequately define the extent of the injury and injury to the musculotendinous structures. Most avulsion fractures are managed conservatively.