Meyers and McKeever’s classification of ACL avulsion fractures is a special type of investigating the fracture pattern, severity, degree, and fracture angle of avulsion fracture of the anterior tibial eminence, anterior cruciate ligament(ACL) avulsion fractures, and injury tibial spine fracture, is an intra-articular fracture of the bony attachment of the ACL. Avulsion fractures were classified into three types by Meyers and McKeever Type I-undisplaced, Type II-anterior third displacement, and Type III completely displaced. Type I injuries are best treated conservatively. Treatment of displaced fractures is controversial and multiple methods have been described.
Meyers and McKeever’s classification of ACL avulsion fractures
Meyers and McKeever’s classification of ACL avulsion fractures is the most frequently employed system to describe ACL avulsion fractures.
Classification
Under the Meyers and McKeever system (with modifications by Zaricznyj) injuries are classified into four main types:
- type 1: minimally/nondisplaced fragment
- type 2: anterior elevation of the fragment
- type 3: complete separation of the fragment
- type 3a: involves a small portion of eminence
- type 3b: involves the majority of the eminence
- type 4: comminuted avulsion or rotation of the fracture fragment
or
- Type 1 – minimally/non-displaced fragment
- Type 2 – anterior elevation of the fragment
- Type 3 – complete separation of the fragment. 3b – Involves the majority of the eminence.
- Type 4 – comminuted avulsion or a rotation of the fragment.
Case Discussion
These illustrations are based on the Meyers and McKeever classification system.
- Type 1 – minimally/non-displaced fragment
- Type 2 – anterior elevation of the fragment
- Type 3 – complete separation of the fragment. 3b – Involves the majority of the eminence.
- Type 4 – comminuted avulsion or a rotation of the fragment.
I’ve lightly indicated a type 4 “b” to show a rotational type 4 in contrast to the comminuted type 4. No type 4b has been described in the literature. Both rotated fragments and comminuted avulsions have been referred to as just “type 4.
Classification According to orthobulet.com
Modified Meyers and McKeever Classification
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Modified Meyers and McKeever Classification
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Type I
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Nondisplaced (<3mm)
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Type II
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Minimally displaced with intact posterior hinge
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Type III
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Completely displaced
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Type III+
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Type III fracture with rotation
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Type IV
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Completely displaced, rotated, comminuted
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References
