Badrinath Raghav, Carter Cordelia W
Department of Orthopaedic Surgery, UCSD School of Medicine, San Diego, CA (Dr. Badrinath); and Department of Orthopaedic Surgery, NYU School of Medicine, New York, NY (Dr. Carter).
J Am Acad Orthop Surg Glob Res Rev. 2018 Oct 23;2(10):e079. doi: 10.5435/JAAOSGlobal-D-17-00079. eCollection 2018 Oct.
Multiligamentous knee injuries occur rarely in the pediatric population. Few reports are available in the existing literature; furthermore, no longitudinal studies regarding the choice of treatment and long-term outcomes for this unique population have been published. To fill this knowledge gap, the literature on multiligamentous injuries of the knee in the adult population is commonly used as a guideline in clinical decision making for children and adolescents. However, the developing bone and physis are often weaker than the ligamentous structures of the knee-particularly during periods of rapid growth-and may be the first to fail in the event of injury or trauma. Bony avulsion fractures and peri-physeal fractures, rather than mid-substance ligamentous ruptures, may result. Patients with skeletal immaturity may therefore present with different patterns of multiligamentous injury after acute trauma to the knee. This article describes the clinical presentation, our treatment approach, and short-term outcomes for three pediatric patients with multiligamentous injuries of the knee and reviews the current literature relating to these uncommon injuries.
多韧带膝关节损伤在儿童群体中很少见。现有文献中的报道很少；此外，尚未发表关于这一特殊人群治疗选择和长期预后的纵向研究。为了填补这一知识空白，成人多韧带膝关节损伤的文献通常被用作儿童和青少年临床决策的指南。然而，发育中的骨骼和骨骺通常比膝关节的韧带结构更脆弱，尤其是在快速生长时期，在受伤或创伤时可能首先出现问题。可能会导致骨撕脱骨折和骨骺周围骨折，而不是韧带中部断裂。因此，骨骼未成熟的患者在膝关节急性创伤后可能会出现不同类型的多韧带损伤。本文描述了3例膝关节多韧带损伤儿科患者的临床表现、我们的治疗方法和短期预后，并综述了与这些罕见损伤相关的当前文献。
