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MoMortazavi,MD (520)222-8076 www.sparcctucson.com AvulsionFracture Whatisanavulsionfracture? Anavulsionfractureisacommontypeoffractureinwhichafragmentofboneispulledawayfromtherestof thebonebyatendonorligament.Thesefracturesoccurwhenalargeamountofforceisplacedonatendon orligamentand,insteadoftearing,itpullsawayfromthebonetakingapieceofbonewithit.Ingrowing childrenandadolescents,ligamentsandtendonsareoftenstrongerthanthesurroundingbone,causingalittle ofthebonetobepulledawayatitsweakestpoint.Avulsionfracturesoccurcommonlyinthefingersandtoes but,inyoungathletes,theycanalsooccurinthepelvis,elbowandfootwheretendonsattachtogrowth centers.Thesegrowthcentersaremadeofweaker,softercartilageandcanbepulledawayduringaforceful contractionofthemuscle. Whatarethesignsandsymptoms? Symptomsmayvaryforeachperson,someoftheseinclude: • Painandswellingatthesiteofinjury.Bruisingmayappearafewdaysafter. • Strongpainthatdoesnotgoawayfollowingasudden,forcefulinjury. • Unwillingnesstousetheinjuredjointorextremity. • Apopmaybeheardorfeltatthetimeofinjury. Howdoyoudiagnoseit? Likemostfractures,theonlywaytotrulydiagnoseanavulsionfractureiswithanx-ray.Yourdoctorwillorder severalviewsoftheareatodetermineifanyfractureispresent.Anavulsionfracturewillappearasasmall fleckofbonerestingnexttothelargerbonefromwhichithasbeenpulled.Sometimes,anMRIorCTscanmay beorderedtofurtherchecktheinjury,howeveradditionalstudiesarenotoftenneeded. Howisittreated? Careofanavulsionfracturedependsonthesizeofthepiecethathasbeenpulledoffandhowfarawayfrom theboneithasbeenpulledaway.Mostavulsionfracturescanbetreatedwithoutsurgerywithrest,painand swellingcontrolandbracingorsplinting.Thesefracturesusuallydonotrequireacast,butkeepingthebody partimmobilizedandprotectediskeytoproperhealing.Insomerarecases,surgerymaybeneededtoplace thebonebackincorrectalignmentuntilenoughhealinghasoccurred.Completehealingcantake4-8weeks. Yourdoctormayorderphysicaltherapytohelpgetbackmotion,strengthandfunctionofthebodypartonce enoughhealinghastakenplace. References: Children’sHospitalColoradoSportsMedicineProgramforyoungathletes,AmericanAcademyofPediatrics,AmericanMedical SocietyofSportsMedicine
