From the Department of Orthopaedics, Children's Hospital of Philadelphia, Philadelphia, PA (Mr. DeFrancesco, Ms. Storey, and Dr. Ganley), the Department of Orthopedics, St. Luke's Sports Medicine, Boise, ID (Dr. Shea), and the Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA (Dr. Kocher).
J Am Acad Orthop Surg. 2018 Feb 1;26(3):e50-e61. doi: 10.5435/JAAOS-D-17-00294.
Although initially considered rare, anterior cruciate ligament (ACL) ruptures in pediatric patients recently have increased substantially as a result of greater awareness of the injury and increased participation in youth sports. Although pediatric patients with an ACL injury and a clinically stable joint may handle the injury well and return to sports activity without requiring surgical reconstruction, young, active patients with an ACL rupture and an unstable joint may be good candidates for ACL reconstruction to prevent ongoing instability and additional joint damage. ACL reconstruction techniques have been developed to prevent physeal injury in skeletally immature patients. The surgical treatment of skeletally immature patients with an ACL rupture may differ from that of adults with an ACL rupture and presents unique challenges with regard to reconstruction technique selection, graft preparation, rehabilitation, and return to sports activity. Orthopaedic surgeons should understand various physeal-sparing ACL reconstruction techniques and the general challenges associated with the surgical management of ACL ruptures in pediatric patients.
虽然最初被认为很少见，但由于对这种损伤的认识提高以及青少年参与体育运动的增加，最近儿童前交叉韧带（ACL）撕裂的情况大幅增加。尽管 ACL 损伤且关节临床稳定的儿科患者可能处理得很好，并在无需手术重建的情况下恢复运动活动，但 ACL 撕裂且关节不稳定的年轻、活跃的患者可能是 ACL 重建的良好候选者，以防止持续的不稳定和进一步的关节损伤。ACL 重建技术已经发展起来，以防止骺板未成熟患者的骺板损伤。ACL 撕裂的骨骼未成熟患者的手术治疗可能与 ACL 撕裂的成年人不同，在重建技术选择、移植物准备、康复和重返运动活动方面存在独特的挑战。矫形外科医生应了解各种骺板保留 ACL 重建技术以及与儿科患者 ACL 撕裂的手术管理相关的一般挑战。
