Anterior Cruciate Ligament Ruptures in the Skeletally Immature Current State of the Art.

Anterior cruciate ligament (ACL) injuries in children and adolescents are increasing every year. This patient population has unique risk factors and treatment considerations depending on specific patient factors and the level of bone maturity. This review summarizes the current data regarding pertinent features of the history and physical exam, indications for nonoperative management, assessment of skeletal maturity, and the surgical management of patients based on their unique physeal considerations. To prevent physeal injury, the surgical considerations differ from the adult population with respect to graft choice, location of fixation, reconstruction technique, and postoperative protocol. Orthopedic surgeons should be familiar with the various surgical techniques, graft selection choices, postoperative rehabilitation programs, controversies, and outcomes associated with the management of ACL injuries in the pediatric population.