Advances in the Treatment of Anterior Cruciate Ligament Tibial Insertion Avulsion Fractures

Anterior cruciate ligament (ACL) tibial insertion avulsion fracture is a bony avulsion injury at the ACL tibial insertion site caused by trauma. Although clinically uncommon, with an annual incidence of approximately 3 per 100,000, it represents an intra-articular fracture that often compromises knee stability due to concomitant ACL functional impairment and meniscal injuries, causing significant clinical challenges. Consequently, the selection of appropriate internal fixation methods and surgical approaches is critical. Current debates persist regarding optimal surgical strategies for different fracture subtypes. This review systematically summarizes recent advances in the management of ACL tibial insertion avulsion fractures.