title: Rupture of the anterior cruciate ligament in children: early reconstruction with open physes or delayed reconstruction to skeletal maturity?
abstract: The purpose of this study was to compare two different strategies of management for ACL rupture in skeletally immature patient. In group 1, patients were treated in a children hospital by ACL reconstruction with open physis. In group 2, patients were treated in an adult hospital by delayed reconstruction at skeletal maturity assessed radiologically. Fifty-six consecutive patients were included in this retrospective study. Mean time from injury to surgery in group 1 and 2 was, respectively, 13.5 and 30 months. Patients from group 2 exhibited a higher rate of medial meniscal tears (41%) compare to group 1 (16%) and higher rate of meniscectomy. Both groups had the same rate of lateral meniscal tears. A temporary tibial valgus deformity was reported which was subsequently spontaneously resolved. No definitive growth disturbance was noticed. At 27 months mean follow-up, a best subjective IKDC score was found in group 1. Objective IKDC and radiological results were similar in both groups. Early ACL reconstruction is therefore a recommended option.
authors.affiliation: Service de Chirurgie Orthopédique, de Traumatologie et de Médecine du Sport, Centre Hospitalier Lyon-Sud, Chemin du Grand Revoyer, 69495, Pierre Bénite, Cedex, France. Henry.ju@voila.fr
authors.forename: Julien
authors.initials: J
authors.lastname: Henry
authors.forename: Franck
authors.initials: F
authors.lastname: Chotel
authors.forename: Julien
authors.initials: J
authors.lastname: Chouteau
authors.forename: Michel Henri
authors.initials: MH
authors.lastname: Fessy
authors.forename: Jérôme
authors.initials: J
authors.lastname: Bérard
authors.forename: Bernard
authors.initials: B
authors.lastname: Moyen
mesh_terms: D000293:Adolescent; D000365:Age Determination by Skeleton; D016118:Anterior Cruciate Ligament / Q000503:physiopathology; D000070598:Anterior Cruciate Ligament Injuries; D001265:Athletic Injuries / Q000601:surgery*; D001846:Bone Development; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D012189:Retrospective Studies; D012421:Rupture / Q000209:etiology / Q000601:surgery; D013710:Tendons / Q000637:transplantation*; D013997:Time Factors; D016896:Treatment Outcome