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Avulsion Fractures


Avulsion fractures usually occur in young athletes. They may sprint, punch, slide, or engage in other movements that involve jerky movements or sharp turns. A piece of bone attached to a ligament or tendon separates from the body of the bone. It may take up to 12 weeks to fully heal.

If your child needs surgery or casting, our Fracture Care Clinic opens every day and you do not need an appointment. Surgery rooms get scheduled every morning, so your child receives the care and attention they need right away.


Are Avulsion Fractures Serious

Avulsion FractureYou may wonder if an injury is serious enough to warrant an emergency room visit. Any fracture is serious, including if you think your child has broken a bone; so first go to the emergency room and have your child diagnosed and treated.  Then come see us.  We are pediatric specialists who will ensure your child heals properly and returns to his or her daily routine of having fun.

Types of Avulsion Fractures

  • Pelvic avulsion fracture
  • Fibular avulsion fracture
  • Medial epicondyle avulsion fracture
  • Finger avulsion fracture


An abrupt, strong tug on a tendon while the bone is moving in the opposite direction frequently results in an avulsion fracture. A fifth metatarsal injury, which affects the bone on the outside of the midfoot, serves as an illustration. This bone’s base is where the peroneal tendon connects. When the foot is twisted, the peroneal tendon frequently contracts firmly, pulling the foot obliquely in the opposite direction from the twisting force. Where the tendon joins to the bone, this results in a break in the bone. The good news is that with only rest and patience, these fractures typically heal quickly

What Is the Diagnosis of an Avulsion Fracture?

A physical examination of the affected region, a review of the patient’s medical history, and imaging studies, such as:

  • X-rays
  • CT scan for computerized tomography
  • MRI scan for magnetic resonance imaging
  • Ultrasound

Who is Affected by Avulsion Fractures?

Avulsion fractures are common in children who play sports that include skiers, ballet dancers, football players, and gymnasts. They may do several abrupt turns, leaps, and kicks during their activities. Avulsion fractures, on the other hand, can happen to anybody and cause sprain-like injuries like a twisted ankle. Avulsion fractures hurt, and missing out on a favorite sports or other cherished activities might hurt children much more.

Who Needs Surgery for an Avulsion Fracture?

Surgery is typically not necessary for avulsion fractures. But let’s say your child suffers an injury where the bone linked to the tendon or ligament is located more than 2 cm from the primary bone. One of the following two procedures will be carried out by our doctor:

Open Reduction

After making a cut in the body, the surgeon realigns the bones.

Internal Fixation

To permanently realign bones, the surgeon adds metal hardware. Pins, plates, screws, and rods are a few examples of hardware. During the procedure, your child may fall asleep. Our physician will use the most effective technique, such as a general anesthetic or localized anesthetic like an epidural. Your child won’t experience anything in either scenario.

What is the Recovery Time for Avulsion Fractures?

For a few weeks, your child might have to use a cast or splint. The normal healing time for fractures is three to twelve weeks. A brief period of rest followed by crutches is beneficial for an avulsion fracture in the pelvis or anywhere else where our doctor cannot put a cast. After a few weeks, the doctor can let your child apply weight and restart as tolerated in sporting activities. Ask your doctor when your child may resume his or her sports activities. If your child returns too soon, the child can get hurt once again.

Do I Need to See an Expert for Further Information?

After receiving care at the emergency room, you should visit one of our expert orthopedists. Your child’s skeletal and muscular systems are the focus of orthopedics. You might have to see our doctor as frequently as twice each week, depending on your child’s injury. Our orthopedist will ensure a rapid recovery and request more X-rays as necessary.


Depending on which bone your child has injured, several treatments are available for avulsion fractures.

Treatment for an Ankle Avulsion Fracture

Rest and ice are the primary therapies for an ankle avulsion fracture. As the ankle heals, the child should avoid putting any weight on it and take steps to prevent swelling by elevating the ankle and using ice. Use an ice pack or ice wrapped in a towel to treat an injury. By taking these precautions and applying ice to the wound, parents can stop the bone from suffering more damage. To keep the ankle stable, your doctor could apply a cast or boot. Until the ankle has recovered, your child will need to wear the boot or cast and may need to use crutches to go around to prevent placing weight on the injured ankle. Physical therapy might assist your child in regaining ankle mobility once the fracture has healed. A physical therapist will demonstrate to you how to carry out bone-strengthening and range-of-motion-improving exercises. Your child could require surgery to correct the alignment and anatomy of the bone if it has been too severely misaligned. You can ask your doctor if surgery is required.

Treatment for a Finger Avulsion Fracture

When an item, such as a ball, strikes the tip of your finger and causes it to bend downward, your finger may break. The term “baseball finger” or “mallet finger” may be used to describe this sort of damage. The damage may cause the finger’s tendon to peel away from the bone. Another sort of injury, known as “jersey finger,” is frequent in sports like football and rugby. When a player grabs another player’s jersey, their finger is trapped and pulled, resulting in a “jersey finger.” The tendon pulls away from the bone as a result of this motion. A finger avulsion fracture requires slightly more complicated treatment than typical bone fractures. In order to prevent further damage to the finger, the finger must be stabilized. To make sure your child receives the proper care, our doctors specialize in children and specialize in hands.

For a few weeks, your child will probably need to keep the injured finger straight with a splint while it heals. Physical therapy can help restore mobility and functionality in the finger once it has healed. Surgery may be necessary for some circumstances to treat a wounded finger. During surgery, a surgeon will place pins in the bone to keep the broken bone fragments together as they heal. It could also need sewing a ripped tendon back together, depending on the kind of damage.

Treatment for a Hip Avulsion Fracture

Rest is the main course of action for pelvic or hip avulsion fractures. To prevent further damage to the hip while it heals, your child’s doctor may advise using crutches. In addition, the doctor will recommend that the hip be treated with ice for 20 minutes at a time for the first several days following the accident. Your doctor will recommend a physical therapist for assistance in strengthening and stretching your child’s hip once the fracture has mostly healed. Surgery might be needed to repair the bone if it has moved far from its original position. To maintain the hip in place as it heals, surgeons may employ metal pins or screws.

Will my Child be Asleep During Surgery?

During the procedure, your child will be asleep. Your physician will use the most effective technique, such as a general anesthetic or localized anesthetic like an epidural. Your child won’t experience anything in either scenario.

How can I Lower my Child’s Chance of Suffering an Avulsion Fracture?

Avulsion fractures are difficult to avoid, although it is feasible to lower the risk. Children playing sports can lower their risk of an avulsion fracture by doing the following:

  1. Before practicing or playing a game, spend five to ten minutes warming up.
  2. Avoid pushing your child to complete a task that may be too challenging.
  3. Your child should be able to avoid any injuries by exercising caution.


A fragment of bone that rips away from the surrounding bone results in an avulsion fracture. Depending on the degree of bone displacement, certain avulsion fractures are simple to identify and diagnose. Since the soft tissue maintains the bone in place in some cases and the bone separation is not as obvious, it might be challenging to detect certain conditions. Based on the location and seriousness of the injury, your doctor will decide how to treat your child. Although immobilization is a common treatment for many minor avulsion fractures, surgery may be necessary in other cases. Before children return to sports or other activities following an avulsion fracture, parents should consult with our specialists.

Call 214-556-0590 to make an appointment.

Comprehensive services for children from birth through adolescence at four convenient locations: Arlington, Dallas, Frisco and McKinney.