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PCL avulsion fracture - comminuted

Case contributed by Matt Skalski
Diagnosis certain

Presentation

Recent motorcycle accident

Patient Data

Age: 30 years
Gender: Male

There is an osseous fragment in the posteromedial joint space of the knee at the expected location of the PCL, suggesting an avulsion of the PCL inserion. There is also an associated suprapatellar effusion.  No other fractures are identified. 

The avulsed segment identified on the plain film is well characterized, with moderate displacement of the largest fragment and multiple comminuted fragments. No other fractures are identified. 

Diagram

The type 3 avulsion fracture of the PCL indicates a completely displaced fragment. 

Case Discussion

This fracture represents a type 3 avulsion fracture of the PCL as it is comminuted and displaced. Other important structures that need to be evaluated include the posterlateral corner structures, as they are involved in 60% of PCL injuries. 

This case is courtesy of Eric White, MD, who generously shared it with me. 

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