This fracture is usually encountered in 8- to 15-year-old youths, who most often relate a history of a fall from a bicycle. This causes the intercondylar eminence to be avulsed from the tibia, resulting in a painful and acutely swollen knee. The patient has a positive Lachman's test and a drawer sign, and may have concomitant medial collateral ligamentous instability to valgus stress testing. Radiographs usually reveal evidence of a fracture on the lateral view with the knee slightly flexed. The treatment is immobilization in full extension in most instances, as this can reduce the fracture fragment to its anatomic state. Persistent displacement of the fracture should be treated surgically. The concomitant injuries to the medial collateral ligaments do not often require surgical intervention and can be treated while the patient is recovering from the fracture. The prognosis with proper treatment is good.28
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