title: Paediatric ACL repair reinforced with temporary internal bracing.
abstract: OBJECTIVE
  Instability following non-operative treatment of anterior cruciate ligament (ACL) rupture in young children frequently results in secondary chondral and/or meniscal injuries. Therefore, many contemporary surgeons advocate ACL reconstruction in these patients, despite the challenges posed by peri-articular physes and the high early failure rate. We report a novel management approach, comprising direct ACL repair reinforced by a temporary internal brace in three children.
  
  
  METHODS
  Two patients (aged 5 and 6 years) with complete proximal ACL ruptures and a third (aged seven) with an associated tibial spine avulsion underwent direct surgical repair, supplemented with an internal brace that was removed after 3 months.
  
  
  RESULTS
  Second-look arthroscopy, examination and imaging at 3 months confirmed knee stability and complete ACL healing in all cases. Normal activities were resumed at 4 months, and excellent objective measures of function, without limb growth disturbance, were noted beyond 2 years.
  
  
  CONCLUSIONS
  ACL repair in young children using this technique negates the requirement and potential morbidity of graft harvest and demonstrates the potential for excellent outcome as an attractive alternative to ACL reconstruction, where an adequate ACL remnant permits direct repair.
  
  
  METHODS
  IV.
authors.affiliation: Department of Orthopaedics, North Hampshire Hospitals NHS Foundation Trust, Aldermaston Road, Basingstoke, Hampshire, RG24 9NA, UK.|Department of Sport and Exercise, Sport and Exercise Research Centre, University of Winchester, Winchester, SO22 4NR, UK.
authors.forename: James O
authors.initials: JO
authors.lastname: Smith
authors.affiliation: Department of Orthopaedics, North Hampshire Hospitals NHS Foundation Trust, Aldermaston Road, Basingstoke, Hampshire, RG24 9NA, UK.|Department of Sport and Exercise, Sport and Exercise Research Centre, University of Winchester, Winchester, SO22 4NR, UK.
authors.forename: Sam K
authors.initials: SK
authors.lastname: Yasen
authors.affiliation: Department of Orthopaedics, North Hampshire Hospitals NHS Foundation Trust, Aldermaston Road, Basingstoke, Hampshire, RG24 9NA, UK.|Department of Sport and Exercise, Sport and Exercise Research Centre, University of Winchester, Winchester, SO22 4NR, UK.
authors.forename: Harry C
authors.initials: HC
authors.lastname: Palmer
authors.affiliation: Department of Orthopaedics, North Hampshire Hospitals NHS Foundation Trust, Aldermaston Road, Basingstoke, Hampshire, RG24 9NA, UK.|Department of Sport and Exercise, Sport and Exercise Research Centre, University of Winchester, Winchester, SO22 4NR, UK.
authors.forename: Breck R
authors.initials: BR
authors.lastname: Lord
authors.affiliation: Department of Orthopaedics, North Hampshire Hospitals NHS Foundation Trust, Aldermaston Road, Basingstoke, Hampshire, RG24 9NA, UK.|Department of Sport and Exercise, Sport and Exercise Research Centre, University of Winchester, Winchester, SO22 4NR, UK.
authors.forename: Edward M
authors.initials: EM
authors.lastname: Britton
authors.affiliation: Department of Orthopaedics, North Hampshire Hospitals NHS Foundation Trust, Aldermaston Road, Basingstoke, Hampshire, RG24 9NA, UK. wilsonortho@gmail.com.|Department of Sport and Exercise, Sport and Exercise Research Centre, University of Winchester, Winchester, SO22 4NR, UK. wilsonortho@gmail.com.
authors.forename: Adrian J
authors.initials: AJ
authors.lastname: Wilson
mesh_terms: D000070598:Anterior Cruciate Ligament Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001182:Arthroscopy / Q000379:methods; D001915:Braces; D002648:Child; D005260:Female; D006132:Growth Plate; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D024162:Second-Look Surgery; D013977:Tibia / Q000601:surgery; D013978:Tibial Fractures / Q000601:surgery
keywords: ACL repair; Internal bracing; Paediatric ACL