{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:29:35Z","timestamp":1787754575810,"version":"build-2784847793"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JBJS Case Connector"],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>A 13-year-old female gymnast presented with medial knee pain despite several months of nonoperative management for a valgus hyperextension injury resulting in a bony avulsion fracture of the medial collateral ligament (MCL) origin at the medial femoral condyle. The MCL was repaired via open reduction and internal fixation (ORIF) with a single 4.0 mm cannulated screw and washer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>ORIF is a successful treatment option for extra-articular bony MCL origin avulsion fractures that fail conservative treatment. Following surgical intervention and structured physical therapy, our patient had full return to sports at 10 months.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.17.00281","type":"journal-article","created":{"date-parts":[[2019,5,13]],"date-time":"2019-05-13T06:14:08Z","timestamp":1557728048000},"page":"e0281-e0281","source":"Crossref","is-referenced-by-count":5,"title":["Operative Treatment for a Painful Nonunion Avulsion Fracture of the Femoral Attachment of the Medial Collateral Ligament in a Teenager"],"prefix":"10.2106","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4895-1046","authenticated-orcid":false,"given":"Jacob G.","family":"Calcei","sequence":"first","affiliation":[{"name":"Department of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jensen K.","family":"Henry","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joash R.","family":"Suryavanshi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan M.","family":"Schachne","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter D.","family":"Fabricant","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,4]]},"reference":[{"issue":"4","key":"bib1-20230712","doi-asserted-by":"crossref","first-page":"665","DOI":"10.2106\/00004623-197456040-00002","article-title":"The prime static stabilizer of the medial side of the knee","volume":"56","author":"Warren","year":"1974","journal-title":"J Bone Joint Surg Am."},{"issue":"2","key":"bib2-20230712","doi-asserted-by":"crossref","first-page":"159","DOI":"10.2106\/00004623-197658020-00001","article-title":"Classification of knee ligament instabilities: part I. The medial compartment and cruciate ligaments","volume":"58","author":"Hughston","year":"1976","journal-title":"J Bone Joint Surg Am."},{"issue":"9","key":"bib3-20230712","doi-asserted-by":"crossref","first-page":"2000","DOI":"10.2106\/00004623-200709000-00016","article-title":"The anatomy of the medial part of the knee","volume":"89","author":"LaPrade","year":"2007","journal-title":"J Bone Joint Surg Am."},{"issue":"6","key":"bib4-20230712","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1308\/147870804704","article-title":"Avulsion of the common origin of the medial collateral and medial patello-femoral ligaments","volume":"86","author":"Trikha","year":"2004","journal-title":"Ann R Coll Surg Engl."},{"issue":"1","key":"bib5-20230712","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1177\/230949900701500117","article-title":"Medial collateral ligament avulsion from both tibial and femoral attachments: a case report","volume":"15","author":"Naik","year":"2007","journal-title":"J Orthop Surg (Hong Kong)."},{"issue":"1","key":"bib6-20230712","doi-asserted-by":"crossref","first-page":"56","DOI":"10.2106\/00004623-197961010-00011","article-title":"The supporting structures and layers on the medial side of the knee: an anatomical analysis","volume":"61","author":"Warren","year":"1979","journal-title":"J Bone Joint Surg Am."},{"issue":"3","key":"bib7-20230712","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1007\/s00167-005-0682-1","article-title":"Surgical anatomy of the medial collateral ligament and the posteromedial capsule of the knee","volume":"14","author":"Wymenga","year":"2006","journal-title":"Knee Surg Sports Traumatol Arthrosc."},{"issue":"5","key":"bib8-20230712","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1302\/0301-620X.86B5.14853","article-title":"The posteromedial corner revisited: an anatomical description of the passive restraining structures of the medial aspect of the human knee","volume":"86","author":"Robinson","year":"2004","journal-title":"J Bone Joint Surg Br."},{"issue":"6","key":"bib9-20230712","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1177\/0363546510387765","article-title":"Management of medial-sided knee injuries, part 2: posteromedial corner","volume":"39","author":"Tibor","year":"2011","journal-title":"Am J Sports Med."},{"issue":"2","key":"bib10-20230712","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1177\/0363546508324969","article-title":"Medial collateral ligament injuries and subsequent load on the anterior cruciate ligament: a biomechanical evaluation in a cadaveric model","volume":"37","author":"Battaglia","year":"2009","journal-title":"Am J Sports Med."},{"issue":"391","key":"bib11-20230712","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1097\/00003086-200110000-00031","article-title":"Strain in the human medial collateral ligament during valgus loading of the knee","author":"Gardiner","year":"2001","journal-title":"Clin Orthop Relat Res."},{"issue":"3","key":"bib12-20230712","doi-asserted-by":"crossref","first-page":"152","DOI":"10.5435\/00124635-200903000-00004","article-title":"Treatment of medial collateral ligament injuries","volume":"17","author":"Miyamoto","year":"2009","journal-title":"J Am Acad Orthop Surg."},{"issue":"5","key":"bib13-20230712","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1177\/0363546510385999","article-title":"Management of medial-sided knee injuries, part 1: medial collateral ligament","volume":"39","author":"Marchant","year":"2011","journal-title":"Am J Sports Med."},{"issue":"5","key":"bib14-20230712","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1177\/0363546514524524","article-title":"The epidemiology of medial collateral ligament sprains in young athletes","volume":"42","author":"Roach","year":"2014","journal-title":"Am J Sports Med."},{"issue":"2","key":"bib15-20230712","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1097\/01.jsa.0000212311.77817.c8","article-title":"Evaluation and treatment of chronic medial collateral ligament injuries of the knee","volume":"14","author":"Azar","year":"2006","journal-title":"Sports Med Arthrosc."},{"issue":"2","key":"bib16-20230712","doi-asserted-by":"crossref","first-page":"147","DOI":"10.2165\/00007256-199621020-00005","article-title":"Medial collateral ligament injuries in athletes","volume":"21","author":"Reider","year":"1996","journal-title":"Sports Med."},{"issue":"5","key":"bib17-20230712","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.2106\/JBJS.I.01229","article-title":"Injuries to the medial collateral ligament and associated medial structures of the knee","volume":"92","author":"Wijdicks","year":"2010","journal-title":"J Bone Joint Surg Am."},{"issue":"1","key":"bib18-20230712","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1007\/s11999-009-0992-6","article-title":"Case reports: a Stener-like lesion of the medial collateral ligament of the knee","volume":"468","author":"Corten","year":"2010","journal-title":"Clin Orthop Relat Res."},{"issue":"5","key":"bib19-20230712","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1177\/036354658301100511","article-title":"The nonoperative treatment of grade I and II medial collateral ligament injuries to the knee","volume":"11","author":"Holden","year":"1983","journal-title":"Am J Sports Med."},{"issue":"2","key":"bib20-20230712","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1007\/BF01565459","article-title":"Non-operative treatment of acute medial collateral ligament lesions of the knee joint","volume":"1","author":"Petermann","year":"1993","journal-title":"Knee Surg Sports Traumatol Arthrosc."},{"issue":"3","key":"bib21-20230712","doi-asserted-by":"crossref","first-page":"323","DOI":"10.2106\/00004623-198365030-00005","article-title":"Non-operative treatment of complete tears of the medial collateral ligament of the knee","volume":"65","author":"Indelicato","year":"1983","journal-title":"J Bone Joint Surg Am."},{"key":"bib22-20230712","first-page":"77","article-title":"MCL injuries of the knee: current concepts review","volume":"26","author":"Phisitkul","year":"2006","journal-title":"Iowa Orthop J."},{"issue":"5","key":"bib23-20230712","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1177\/0363546510383002","article-title":"Reliability, validity, and responsiveness of a modified International Knee Documentation Committee Subjective Knee Form (Pedi-IKDC) in children with knee disorders","volume":"39","author":"Kocher","year":"2011","journal-title":"Am J Sports Med."},{"issue":"10","key":"bib24-20230712","doi-asserted-by":"crossref","first-page":"2421","DOI":"10.1177\/0363546513496548","article-title":"Development and validation of a pediatric sports activity rating Scale: the Hospital for Special Surgery Pediatric Functional Activity Brief Scale (HSS Pedi-FABS)","volume":"41","author":"Fabricant","year":"2013","journal-title":"Am J Sports Med."},{"issue":"3","key":"bib25-20230712","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1097\/BPO.0000000000000894","article-title":"Symptomatic venous thromboembolism after adolescent knee arthroscopy","volume":"39","author":"Murphy","year":"2019","journal-title":"J Pediatr Orthop."},{"issue":"6","key":"bib26-20230712","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1177\/036354658100900605","article-title":"Medial collateral ligament injuries in football: nonoperative management of grade I and grade II sprains","volume":"9","author":"Derscheid","year":"1981","journal-title":"Am J Sports Med."},{"issue":"2","key":"bib27-20230712","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1177\/036354659602400207","article-title":"Long-term prognosis of isolated partial medial collateral ligament ruptures: a ten-year clinical and radiographic evaluation of a prospectively observed group of patients","volume":"24","author":"Lundberg","year":"1996","journal-title":"Am J Sports Med."},{"issue":"8","key":"bib28-20230712","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.2106\/00004623-198769080-00013","article-title":"Healing of the medial collateral ligament in rats: the effects of repair, motion, and secondary stabilizing ligaments","volume":"69","author":"Hart","year":"1987","journal-title":"J Bone Joint Surg Am."},{"issue":"6","key":"bib29-20230712","doi-asserted-by":"crossref","first-page":"364","DOI":"10.5435\/00124635-200011000-00004","article-title":"Healing and repair of ligament injuries in the knee","volume":"8","author":"Woo","year":"2000","journal-title":"J Am Acad Orthop Surg."},{"issue":"5","key":"bib30-20230712","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1177\/036354659101900517","article-title":"Healing of the medial collateral ligament in unstable rat knees","volume":"19","author":"Lechner","year":"1991","journal-title":"Am J Sports Med."}],"container-title":["JBJS Case Connector"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/01709767-201906000-00007","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:29:29Z","timestamp":1787750969000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01709767-201906000-00007"}},"subtitle":["A Case Report"],"short-title":[],"issued":{"date-parts":[[2019,4]]},"references-count":30,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.cc.17.00281","relation":{},"ISSN":["2160-3251"],"issn-type":[{"value":"2160-3251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,4]]}}}