Knee injury in childhood: a retrospective analysis of patients of the Zurich Pediatric Surgery University Clinic

Abstract

During the past 10 years (1976-1985) we treated more than 1000 knee injuries at our department. More than 90% were minor traumas and could be treated on an outpatient basis. In 78 children x-ray or clinical examination revealed a haemarthros which was confirmed by aspiration. This group represents 7.6% of patients. In 38 patients a major knee injury led to surgical treatment. Conservative treatment was successful in 40 children. In 26 cases we could not find the origin of haemarthrosis by clinical or radiological examination. 14 children showed major lesions, mostly undislocated fractures of the patella or avulsion of the cruciate ligaments. In all 78 patients haemarthrosis was evacuated by aspiration or during operation and the injured knee joint was immobilised for 4-6 weeks. 56 of the 78 patients (72%) were radiologically and clinically re-evaluated after 5 1/2 years (1-11 years). The aim of this presentation is to judge, based on our own patients, if arthroscopy in paediatric knee injuries is mandatory in every case as demanded by different authors. We were most interested to find out whether diagnostic errors lead to false, positive or negative indication for operation. In very few cases only our diagnosis was based on arthroscopic evaluation.