Avulsion Fracture

Medically reviewed by William Morrison, MD on April 13, 2017Written by Stephanie Watson

What is an avulsion fracture?

A fracture is a break or crack in a bone that often results from an injury. With an avulsion fracture, an injury to the bone occurs near where the bone attaches to a tendon or ligament. When the fracture happens, the tendon or ligament pulls away, and a small piece of bone pulls away with it. Avulsion fractures can happen in people who play sports.

These fractures most often affect bones in the elbow, hip, and ankle. Sometimes you can get an avulsion fracture in other bones, such as the hand, finger, shoulder, or knee.

Symptoms of an avulsion fracture include:

  • sudden, severe pain in the area of the fracture
  • swelling
  • bruising
  • limited movement
  • pain when you try to move the bone
  • instability of a joint or loss of function

Your doctor will perform a physical examination of the affected bone to see whether you can bend and straighten it. The doctor also may order X-rays to determine if you’ve fractured the bone.

Treatment

The treatment for an avulsion fracture varies based on which bone you’ve fractured.

Treatment for an ankle avulsion fracture

The main treatments for an ankle avulsion fracture are rest and icing. Keep weight off the ankle until it has healed, and take measures to reduce swelling by elevating the ankle and applying ice. When icing an injury, use an ice pack or ice wrapped in a towel. These steps will prevent further injury to the bone, and icing the injury will also relieve pain.

Your doctor might put a cast or boot on the ankle to keep it stable. You’ll need to wear the boot or cast until the ankle has healed, and you might have to use crutches to get around to avoid putting weight on the ankle.

Once the fracture has healed, physical therapy can help you regain motion in your ankle. Your physical therapist will show you how to perform exercises that strengthen the bone and improve your range of motion.

If the bone is pushed too far out of place, you may need surgery to restore its alignment and anatomy. Your doctor can tell you whether surgery is necessary.

Treatment for a finger avulsion fracture

Your finger can become fractured when an object, like a ball, hits the tip of it and forces it to bend down. This type of injury is sometimes called “baseball finger” or “mallet finger.” The injury can pull the tendon in the finger away from the bone.

Another type of injury, which is common in sports like football and rugby, is called “jersey finger.” Jersey finger happens when one player grabs another player’s jersey and their finger gets caught and pulled. This movement causes the tendon to pull away from the bone.

Treatment for a finger avulsion fracture is a little more complex than with other bones. You’ll need to keep the finger stable so you don’t injure it further, but you don’t want to keep the finger so still that it loses mobility. Your doctor might refer you to a hand specialist to make sure you get the right treatment.

You’ll most likely have to wear a splint on the affected finger for a few weeks to hold it straight until it heals. Once it heals, physical therapy can help you regain movement and function in the finger.

In certain cases, surgery will be required to treat the injured finger. Surgery will involve a surgeon inserting pins in the bone to hold the pieces of bone together while they heal. Depending on the nature of the injury, it may also involve stitching together a torn tendon.

Treatment for a hip avulsion fracture

The primary treatment for a hip or pelvic avulsion fracture is rest. Your doctor might recommend that you use crutches to keep weight off the hip while it heals.

Apply ice to the hip for 20 minutes at a time for the first couple of days after the injury. Once the fracture has mostly healed, see a physical therapist to help you stretch and strengthen the hip.

If the bone has pulled far away from its original place, you might require surgery to fix it. Surgeons sometimes use metal pins or screws to keep the hip in place while it heals.

Recovery

Depending on your injury, it may take eight weeks or more for the fracture to heal. Rest the area during that time. If your ankle or hip is fractured, you may need to use crutches to keep weight off the affected area. Your recovery could take longer if you need surgery.

Risk factors

Avulsion fractures often happen in people who play sports. They’re most common in young athletes whose bones are still growing. Kids may be more vulnerable to these fractures if they play or practice too hard or too often, or if they use the wrong techniques.

Prevention tips

Before playing sports, warm up and stretch for at least 5 to 10 minutes. This will make your muscles more flexible and prevent injuries.

Don’t push yourself too hard in any sport. Develop your skills slowly over time, and avoid making sudden movements, like twists or other quick direction changes.

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