Ramteke Swapnil U, Jaiswal Pratik R, Tikhile Priya
Sports Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education & Research, Wardha, IND.
Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education & Research, Wardha, IND.
Cureus. 2024 May 6;16(5):e59758. doi: 10.7759/cureus.59758. eCollection 2024 May.
Anterior cruciate ligament (ACL) tears represent common occurrences in sports, particularly posing significant risks to young athletes. The diagnostic methods for ACL injury include magnetic resonance imaging (MRI), arthroscopy, and physical examination. Management of this injury can be done both operative and nonoperatively. Pediatric growth plate fractures are classified under the Salter-Harris classification. A 13-year-old male athlete sustained a knee injury during a volleyball match. While landing from a jump after a smash, the athlete directly landed on the ground on his right knee. After this, he reported discomfort and severe anterior knee pain. Due to immobility and pain, he was taken to the emergency unit. Upon radiographic examination, a Salter-Harris Classification Type I fracture was found, indicating epiphyseal slip and separation through the physis of the right proximal tibia medially. An MRI imaging was done to check the integrity of the ACL after the swelling had subsided post-15 days of injury. An MRI identified a bony contusion on the medial tibial plateau, extending to the physeal plate with a Grade II ACL tear. The concurrent occurrence of ACL injury and growth plate injury presents a significant concern. Hence, a referral for physical therapy rehabilitation was given. Our findings highlight the importance of prompt initiation of physical rehabilitation following such injuries. Where non-surgical rehabilitation strategies play a crucial role in managing these cases while focusing on restoring knee stability, promoting healing of the growth plate, and facilitating a safe return to sport. Tailored rehabilitation, including therapeutic exercises, neuromuscular training, and proprioceptive training, is essential for optimizing outcomes and preventing long-term complications. The case underscores the importance of a multidisciplinary approach in managing the complex knee injury of this young athlete.
前交叉韧带（ACL）撕裂在体育运动中很常见，尤其对年轻运动员构成重大风险。ACL损伤的诊断方法包括磁共振成像（MRI）、关节镜检查和体格检查。这种损伤的处理方式有手术和非手术两种。小儿生长板骨折按照Salter-Harris分类法进行分类。一名13岁男性运动员在排球比赛中膝盖受伤。在一次扣杀后落地时，该运动员右膝直接着地。此后，他报告感到不适和膝盖前方剧痛。由于行动不便和疼痛，他被送往急诊室。经影像学检查，发现为Salter-Harris I型骨折，提示右侧胫骨近端内侧骨骺通过骺板滑脱和分离。受伤15天后肿胀消退后，进行了MRI成像以检查ACL的完整性。MRI显示胫骨内侧平台有骨挫伤，延伸至骺板，同时伴有II级ACL撕裂。ACL损伤和生长板损伤同时发生是一个重大问题。因此，安排了物理治疗康复转诊。我们的研究结果强调了此类损伤后及时开始物理康复的重要性。非手术康复策略在处理这些病例中起着关键作用，同时注重恢复膝关节稳定性、促进生长板愈合以及促进安全重返运动。量身定制的康复，包括治疗性锻炼、神经肌肉训练和本体感觉训练，对于优化治疗效果和预防长期并发症至关重要。该病例强调了多学科方法在处理这位年轻运动员复杂膝关节损伤中的重要性。
