UMEM Educational Pearls

Category: Visual Diagnosis

Title: What's the Diagnosis? Written by Zachary Dezman

Posted: 12/2/2012 by Haney Mallemat, MD (Emailed: 12/3/2012) (Updated: 12/3/2012)
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11 year-old boy presents with right knee pain and swelling after falling off of his bicycle. What's the diagnosis?


Answer: Fracture of the intercondylar eminence of the tibia; Meyers & McKeever Grade II (grading system described below)


Intercondylar Eminence Fracture

  • Avulsion of the insertion of the ACL because the ligament stronger than incompletely ossified bone in children
  • Incidence is 3 in 100,000 children
  • Most common injury mechanism
    • Falls from a bicycle
    • Motor vehicle crash
  • Meyers and McKeever’s classification system
    • I (non-displaced) - Generally treated non-operatively with long-leg casting
    • II (hinged fragment)  - Generally treated like Grade I
    • III (displaced) - Requires surgical fixation



Reference: Tudisco, C., et al Intercondylar eminence avulsion fracture in children: long-term follow-up of 14 cases at the end of skeletal growth, J Pediatr Orthop B 19:403–408 c 2010


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