Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London E1 4DG, England, UK.
Surgeon. 2013 Apr;11(2):59-62. doi: 10.1016/j.surge.2012.02.003. Epub 2012 Apr 9.
Anterior cruciate ligament (ACL) injuries have become common in children and adolescents who practice competitive sports, accounting for 0.5-3% of all ACL injuries. Magnetic resonance imaging (MRI) is useful for diagnosis and treatment planning, but is no better than clinical examination, especially when the MRI is interpreted by less experienced health care professionals. Management of ACL deficiency in children is still controversial, but the present trend is towards early reconstruction, because repeated instability episodes may lead to secondary lesions of the knee, and induce meniscal tears and early degenerative alterations of the joint. Postoperatively, complications are rare, and most of the documented growth complications are secondary to avoidable technical errors such as placement of a fixation device across a growth plate. We recommend to reconstruct the ACL paying attention to avoid irreversible damage to the epiphyseal growth plates of the lower femur and upper tibia.
前交叉韧带(ACL)损伤在从事竞技运动的儿童和青少年中较为常见,占所有 ACL 损伤的 0.5-3%。磁共振成像(MRI)有助于诊断和治疗计划,但并不优于临床检查,尤其是当 MRI 由经验较少的医疗保健专业人员解释时。儿童 ACL 缺陷的管理仍存在争议,但目前的趋势是尽早进行重建,因为反复的不稳定发作可能导致膝关节的继发性损伤,并引起半月板撕裂和关节的早期退行性改变。术后并发症罕见,大多数有记录的生长并发症是由于可避免的技术错误引起的,例如将固定装置放置在生长板上。我们建议重建 ACL 时要注意避免对股骨下端和胫骨上端的骺板生长造成不可逆的损伤。