School of Medicine, Imperial College School of Medicine, London, UK.
Department of Trauma and Orthopaedics, Imperial College Healthcare NHS Trust, London, UK.
Br J Hosp Med (Lond). 2021 Apr 2;82(4):1-9. doi: 10.12968/hmed.2020.0707. Epub 2021 Apr 27.
The number of paediatric anterior cruciate ligament injuries is rising at a greater rate than in the adult population, as a result of the increased participation of children and adolescents in sports. This review explores the key presentations, diagnostic and management plans, and prevention methods associated with paediatric anterior cruciate ligament injuries. This injury presents as an acute pop and effusion, with limitations in gait, and can be extremely debilitating. Clinical examination and magnetic resonance imaging are used to diagnose the injury. The pivot shift and Lachman test remain the most valid exams when suspecting an anterior cruciate ligament tear. Management of the injury can be surgical or non-surgical depending on the severity of the tear and associated injuries. The surgical approach chosen is determined by the patient's Tanner classification, considering potential damage to the physes of the bone. Management plans should include rehabilitation consisting of strength, proprioception and neuromuscular training, to maximise the patient's recovery. Injury prevention programmes, consisting of strength training and neuromuscular training, should be followed by young athletes to reduce anterior cruciate ligament injuries. Compliance and earlier implementation coupled with an understanding of the biomechanics of anterior cruciate ligament injuries and verbal feedback maximise the benefit of neuromuscular training.
儿童前交叉韧带损伤的数量呈上升趋势，比成年人更为显著，这是由于儿童和青少年参与运动的增加所致。本综述探讨了与儿童前交叉韧带损伤相关的主要表现、诊断和管理计划以及预防方法。这种损伤表现为急性弹响和肿胀，伴有步态受限，可能非常虚弱。临床检查和磁共振成像用于诊断损伤。在怀疑前交叉韧带撕裂时，枢轴转移和lachman 试验仍然是最有效的检查。根据撕裂的严重程度和相关损伤，损伤的管理可以是手术或非手术。选择的手术方法取决于患者的 tanner 分类，考虑到骨骼骺板的潜在损伤。管理计划应包括康复，包括力量、本体感觉和神经肌肉训练，以最大限度地恢复患者的康复。损伤预防计划，包括力量训练和神经肌肉训练，应遵循年轻运动员，以减少前交叉韧带损伤。顺应性和早期实施，以及对前交叉韧带损伤生物力学的理解和口头反馈，最大限度地提高神经肌肉训练的益处。
