Valgus and flexion deformity after reconstruction of the anterior cruciate ligament in a skeletally immature patient.
Anterior cruciate ligament reconstruction in children with open physes is still a topic of debate. We report a unique case of growth disturbance in valgus and flexion of the distal femoral epiphysis, after an ACL reconstruction in a 14.5-year-old boy. The Clocheville technique using the patellar tendon was performed. The femoral tunnel and tibial groove were both positioned above the growth plates. Eighteen months after ACL reconstruction, the patient had to be re-operated on for a valgus and flexion deformity of the femoral epiphysis. The clinical, radiological and aesthetic results were satisfactory. The angular deformity was caused by the fact that either the femoral tunnel was too close to the posterolateral femoral growth plate or an excessive eccentric traction of the graft in relation to the central point of the knee.
Robert
Henri Emile
HE
Department of Orthopedics and Traumatology, Hospital of North-Mayenne, 53100 Mayenne, France. henri.robert@wanadoo.fr
Casin
Charles
C
D000293:Adolescent; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001863:Bone Screws; D004838:Epiphyses / Q000000981:diagnostic imaging / Q000601:surgery; D005269:Femur / Q000000981:diagnostic imaging / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D016916:Joint Deformities, Acquired / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D008297:Male; D010027:Osteotomy / Q000379:methods*; D017847:Patellar Ligament / Q000637:transplantation*; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000379:methods; D020127:Recovery of Function; D012086:Reoperation / Q000379:methods; D018570:Risk Assessment