What is an avulsion fracture

An avulsion fracture occurs when a small chunk of bone attached to a tendon or ligament gets pulled away (avulse) from the main part of the bone. The ligament or tendon also may be damaged. Avulsion fracture can happen in the hip, ankle, knee, heel, elbow, fingers, or pelvis. The hip, elbow and ankle are the most common locations for avulsion fractures in the young athlete. You may feel a pop and sudden pain when the fracture occurs.

An avulsion fracture can be caused by any activity that involves physical force. It can happen when you fall, kick, jump, or have to speed up or slow down very quickly. It may be caused by direct force, such as a hard tackle in football. Or it may be caused by indirect force, such as making a sudden turn in soccer or basketball.

You may need to spend a few weeks on crutches if you have an avulsion fracture around your hip. An avulsion fracture to your foot or ankle may require a cast or walking boot.

Treatment of an avulsion fracture typically includes resting and icing the affected area, followed by controlled exercises that help restore range of motion, improve muscle strength and promote bone healing. Most avulsion fractures heal very well without surgical intervention.

In rare cases, if the bone fragment and main bone are too far apart to fuse naturally, surgery may be necessary to reunite them. In children, avulsion fractures that involve the growth plates also might require surgery.

What causes avulsion fracture?

An avulsion fracture may be caused by direct force, such as a hard hit in hockey. Indirect force—such as a sudden turn in soccer or basketball—also can cause it. It can be caused by any activity that involves kicking, jumping, or having to speed up or slow down very quickly.

Avulsion fracture symptoms

You may feel a pop and sudden pain when the fracture occurs. You will probably have some pain and swelling in the area of the fracture. Sometimes the area will be bruised.

Symptoms usually improve after the injury heals.

How is avulsion fracture diagnosed?

X-rays are usually used to diagnose a fracture.

Avulsion fracture treatment

Small fractures are usually treated with ice and rest. You may need a splint or a cast. Avulsion fractures rarely cause any problems, such as pain or discomfort, after the injury heals. Follow the splint or cast care instructions your doctor gives you. If you have a splint, don’t take it off unless your doctor tells you to. Follow your doctor’s instructions about using ice and avoiding certain activities.

If avulsion fracture occurs in the leg or foot, you may need to use crutches or wear a special boot while it heals.

You may need surgery if the bone fragment is large and widely separated from the rest of the bone that it won’t heal on its own. Surgery may also be done if a tendon or ligament is badly detached. Surgery may also be done to reattach a tendon or ligament if it is completely or mostly torn from the bone.

You can return to sports or other physical activities after about 6 weeks to 6 months. How long it takes to recover depends on where the injury is, how serious it is, and how it is treated. It also depends on how quickly you have full range of motion without pain. And it may depend on your age and whether you have other health problems.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.