Avulsion fractures usually happen to young athletes. You might be sprinting, hitting, sliding or doing other sports activities that involve quick movements and sudden changes in direction. A piece of bone attached to a ligament or tendon breaks away from the main part of the bone. It might take up to 12 weeks for you to fully heal.
An avulsion fracture is where a small piece of bone attached to a tendon or ligament gets pulled away from the main part of the bone. Ligaments hold your bones, joints and organs in place while tendons connect muscles and bones. In an avulsion fracture, your bone moves one way and your tendon or ligament moves in the opposite direction with a broken chunk of bone in tow. This most often happens when you suddenly change direction.
An avulsion fracture can happen to any bone that’s connected to a tendon or ligament. The bones that are most at-risk of an avulsion fracture include:
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You might wonder if your injury is serious enough to go to the emergency department. It’s understandably difficult to figure out if your symptoms warrant urgent treatment. But any fracture is serious, including avulsion fractures. Take care of yourself by heading to the emergency department if you think you broke a bone. Professional medical treatment ensures that you'll heal safely and return to your regular routine.
People frequently incurring avulsion fractures are athletes and performers such as football players, ballet dancers, gymnasts and skiers. Their activities can involve a lot of sudden changes in direction, leaping and kicking.
However, avulsion fractures can occur in anyone, with injuries similar to sprains such as a twisted ankle.
Avulsion fractures are painful, and an inability to play your favorite sports or do another treasured activity can be painful as well. If you think you’re having issues with your mental or emotional health, let your healthcare provider know. Treatment can help you get through this difficult time.
Playing sports comes with risks. Contact sports like lacrosse, boxing and football, for example, are the most common causes of avulsion fractures. It’s because contact sports involve movements that stress your limbs, such as:
After sudden, severe pain, the most common symptoms of avulsion fractures include:
Speak with your healthcare provider about all your symptoms. It’s helpful for them to know every detail. You can help them figure out the best treatment plan for you by providing as much information as possible.
Your healthcare providers at the emergency department will discuss your injury with you. They’ll ask you questions and perform tests to help diagnose your avulsion fracture. They'll look over the affected area and see if you can move your bones. After that, there might be imaging tests to get a closer look. Tests might include:
Your healthcare providers in the emergency department should ask questions when you arrive. They want to fully understand what happened to you so that you receive the best care possible. Questions might include:
Tell your healthcare provider every detail. It might help with the diagnosis and treatment.
Treatment depends on which bone broke and the type of avulsion fracture. Generally, treatment for an avulsion fracture includes:
After the pain subsides, your healthcare provider might recommend range-of-motion (ROM) exercises monitored by a physical therapist.
Surgery is occasionally required for severe injuries with joint instability.
The stiff tissues that make up your bones begin to heal right after they break. That's why it's so important to immediately align and protect them (that's what a cast does). Your avulsion fracture should heal in just a couple of steps. The steps include:
Most avulsion fractures don't require surgery. But suppose you have, for example, an injury where the bone attached to the tendon or ligament is more than 2 centimeters away from the main bone. Your surgeon should perform one of two procedures:
You may be asleep during your surgery. Your anesthesiologist will provide the most appropriate method such as general anesthesia or regional anesthesia such as an epidural. In either case, you won’t feel anything.
For an avulsion fracture in your pelvis or anywhere else where your healthcare provider can’t apply a cast, a short period of rest followed by crutches is helpful. Your healthcare provider might allow you to apply weight after a few weeks and resume sports activities as tolerable.
Confirm with your healthcare provider about when you can return to sports. You could reinjure yourself if you go back too soon.
You may see an orthopaedist after treatment at the emergency department. Orthopaedists specialize in your skeletal and muscular system. Depending on your injury, you might need to go to an appointment as often as twice a week. Your orthopaedist should monitor your healing and order more X-rays as needed.
It’s difficult to prevent an avulsion fracture, but possible to reduce your risk. Athletes might reduce their risk of an avulsion fracture by taking some helpful steps, including:
Your avulsion fracture can get worse if you don’t follow your healthcare provider’s advice. Be very careful not to put weight on the fracture until your healthcare provider says it’s OK. You could reinjure yourself.
You could get another avulsion fracture in the same place. Take preventative steps to reduce your risk.
Go to the emergency department if you think you have a fracture. An avulsion fracture is a serious medical emergency that needs care.
You might find yourself with questions about avulsion fractures and your specific situation. Asking questions can help you understand what happened to you and what happens next. You could ask some of the following questions when you see your healthcare providers:
A note from Cleveland Clinic
An avulsion fracture is a serious injury that can stop you from playing your favorite sports. You’ll need a cast and rest, and possibly surgery. You should follow up with your healthcare providers for help. They'll work with you to help you design your personal plan of care that gets you back to your regular activities.
Last reviewed by a Cleveland Clinic medical professional on 09/15/2021.
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