Case: 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.
Conclusions: 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.