Fact-sheet: Avulsion fracture


Updated on 03/09/2026 at 10:33 AM

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Definition

During adolescence, apophyses subjected to significant biomechanical stress from muscle traction constitute areas of weakness due to their incomplete fusion.

Avulsion fracture is a traumatic separation of an apophysis in an adolescent whose bone maturation is not yet complete, or in a young adult whose enthesis is stronger than the underlying bone.

Radiography

The entheses that classically constitute sites of weakness should be recognized

Radiographs are the first-line examination.

Pelvis:

  • Anterior inferior iliac spine (rectus femoris)
  • Anterior superior iliac spine (sartorius and tensor fasciae latae)
  • Ischial tuberosity (hamstrings)
  • Greater trochanter (gluteus medius and minimus)
  • Lesser trochanter (iliopsoas)
  • Iliac crest (anterior abdominal wall muscles)
  • Body and inferior pubic ramus (adductors)

Tibia:

  • Tibial tuberosity (patellar ligament)
  • Tibial spines (anterior cruciate ligament)