Recent Injuries of the Ligaments of the Knee Joint in Children

Abstract

SUMMARYThe author's series comprises 17 cases of fresh ligamental injuries to the knee joint in growing individuals, i.e., patients with residual epiphyseal cartilage.A clear difference seems to exist between the ligamental injuries to the knee joint of the adult and those of the child in such a way that children exhibit isolated ruptures to a greater degree. Combined injuries in the strict sense did not occur in the author's series. The general picture is dominated by injuries to the anterior cruciate ligament (11 cases) and these are all located to the tibial attachment and possess bony fragments.Although in adults the tendency is towards a reconstruction and suturing of the ligamental injury in the acute stage we were more conservatively minded with child patients.Only 4 of the 17 cases were given operative treatment, and in all cases an anterior cruciate injury was involved.The collateral ligamental injuries in this series were all of the partial type, localised to the femoral attachments. We did not see in a fresh condition any total injury of the type relatively common in adults. However, we encountered the residual condition of a non-treated injury to the medial collateral ligament with considerable consequences. This case is reported, hut does not belong to the series.Sixteen of the seventeen cases were followed-up and it was found that on isolated occasions one individual had very slight subjective discomfort from the injured knee when playing football, while the others declared themselves to be completely free from subjective trouble. In two cases a slight quadriceps atrophy was ascertained, and one of these two exhibited slightly increased “forward drawer” by comparison with the healthy side.We interpreted the result to mean that it was correct to treat these injuries more conservatively in children than in adults.