Avulsion Fractures

An avulsion fracture is a type of fracture that happens when a sudden, forceful movement causes a tendon or ligament to pull a part of bone away from the rest of the bone. 

Tendons connect your bones and muscles and ligaments keep your joints in place. When a ligament or tendon moves one way and your bone moves the other way, you could get an avulsion fracture. They can be large or small.

What causes an avulsion fracture? 

What activities or movements can lead to an avulsion fracture?

Avulsion fractures typically happen during rapid or intense movements such as:

• Sports where you’re likely to make sudden changes in direction, quick movements or jump or collide with another player or object (such as soccer, basketball, football, ballet, skiing or snowboarding, track, tennis, hockey, lacrosse, boxing or gymnastics)
• Sliding, hitting, throwing, falling or sprinting 
• Accidental falls
• Trauma such as car accidents 
• Heavy, repetitive use of a joint

Who is at higher risk for an avulsion fracture?

While anyone can get an avulsion fracture, it’s more likely in: 

• Young athletes: Especially teens going through growth spurts. Growth plates (areas where bones grow) are weaker than adult bones, making them more likely to break. 
• Most common in boys ages 15–17 and girls ages 13–14 
• People with osteoporosis: Weakened bones increase risk with age. 
• Athletes of all ages: Sports with sudden movements increase your chances. 

In rare cases, avulsion fractures can be linked to infection, cancer, surgery complications or genetic conditions. 

With an avulsion fracture, you may notice symptoms similar to other types of fractures or sprains, such as:

• Pain that’s worse when you move the joint and possibly spreads to nearby areas
• Swelling
• Bruising or discoloration
• Numbness or tingling
• Weakness, less range of motion or trouble moving the injured area
• A popping sensation at the time of the injury

If you have symptoms of an avulsion fracture, you should see a health care provider for diagnosis and treatment right away.

You’ll want to get an exam quickly, since fractures can be serious. You may need to go to an urgent care center or emergency room. Your provider will likely:

• Ask you what happened when the injury occurred and what symptoms you have.
• Perform a physical exam and check for pain, swelling and range of motion.
• Recommend X-rays to confirm the diagnosis. They may suggest MRI, CT scans or ultrasound if your fracture seems more complicated.

Treatment depends on how severe the fracture is and where it’s located. You may want to see a sports medicine or orthopedic specialist for treatment.

What nonsurgical treatments are available?

Most avulsion fractures can be treated with:

• Rest, ice, compression and elevation (RICE) to reduce pain and swelling
• Anti-inflammatory medication
• Restricting your activities
• Splints, casts, walking boots or braces to protect and immobilize the joint while it heals (you may also need to use crutches)
• Rest, if the fracture is in a place like your pelvis where you can’t use a cast to immobilize it
• Physical therapy for strengthening, mobility and recovery

Physical therapy also helps prepare you to return to sports and reduces the risk of future injuries.

While your bone is immobilized, your body creates a type of blood clot around the fracture to protect the bone. Then, bone cells grow from the main bone and the bone chip and gradually connect to each other. 

When is surgery needed for an avulsion fracture?

You may require surgery if the bone fragment has moved too far away (an inch or more) from the main bone to heal on its own.  During the procedure, a surgeon may either realign your bones so they can heal or reattach the bone fragment and stabilize it with screws or pins to fix it in place, or possibly perform a reconstruction of the ligament/tendon.

Avulsion fractures usually heal in 6 to 12 weeks. Recovery may take longer if the injury is severe or needs surgery. 

Your provider will tell you: 

• When it’s safe to return to activities 
• How to avoid reinjury or setbacks 
• What rehab or therapy you may need 

What are the complications of an avulsion fracture?

It's important to treat avulsion fractures. Otherwise, you risk complications such as:

• Chronic pain or stiffness
• Limited mobility in the area
• A bone that doesn't heal or align properly

When should I contact my health care provider?

Contact your health care provider if you notice:

• Pain or swelling in spite of resting the joint
• Signs of infection, such as redness or warmth 

To prevent avulsion fractures, your health care team will talk to you about what caused the fracture, so you can take steps to prevent another one from occurring. 

It can help to:

• Improve muscle strength so they support your joints
• Maintain or improve your flexibility
• Warm up with dynamic exercises 
• Use the right techniques, form and body mechanics when you are taking part in sports and physical activity
• Wear protective gear when you are playing high-impact sports
• Be careful not to overtrain, which can stress your bones

If you think you have an avulsion fracture, don’t wait. Prompt treatment helps ensure proper healing and a safe return to your activities. 

At Banner Health, our orthopedic and sports medicine specialists offer expert care using the latest diagnostic tools and treatment techniques. We’ll create a personalized recovery plan to help you heal and get back to doing what you love. 

Injured during sports or physical activity? 

Our sports medicine experts at Banner Health can diagnose and treat avulsion fractures and other common injuries. Find a specialist and get back to doing what you love.