ACL Injuries in Children
With more and more children involved in sports at a younger age, anterior cruciate ligament (ACL) injuries are on the rise. Treatment for this injury poses some new problems compared with adult injuries. For one thing, bone growth isn't complete yet. Surgery to repair the torn ACL involves drilling through the bone.
In this review article, surgeons report on the timing and type of surgery needed for ACL injuries in the skeletally immature patient. Conservative care without repair at some point is not advised.
Surgery is needed to prevent knee instability. The timing of the repair can be delayed until the bone has stopped growing. But this means the child can't play or compete in athletics. Reconstruction should be done within a month of when the growth plate closes signaling the end of bone growth.
The authors describe four different types of ACL reconstruction for the child or adolescent who is still growing. These include:
The results of using each of these methods are presented. The benefits and problems of each one are summarized. Some procedures can be used with skeletally immature patients, but the child may need further (revision) surgery later.
The goal is to restore joint stability without causing a leg length discrepancy or angular deformity. Many patients are able to return to full participation in the sport of their choice. The surgeon must avoid any method that can result in disturbed bone growth.
References: Aaron K. Schachter, MD, and Andrew S. Rokito, MD. ACL Injuries in the Skeletally Immature Patient. In Orthopedics. May 2007. Vol. 30. No. 5. pp. 365-372.
Back
All content provided by eOrthopod® is a registered trademark of Mosaic Medical Group, L.L.C.. Content is the sole property of Mosaic Medical Group, LLC and used herein by permission. Alteration of these documents in any way is a violation of the copyright.