Rupture of the anterior cruciate ligament in children: early reconstruction with open physes or delayed reconstruction to skeletal maturity?
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.
Henry
Julien
J
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
Chotel
Franck
F
Chouteau
Julien
J
Fessy
Michel Henri
MH
Bérard
Jérôme
J
Moyen
Bernard
B
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