Treatment for the anterior cruciate ligament fracture in children
The anterior cruciate ligament injury in the knee joint in children, especially adolescents is less common in adults, but the recent it has an upward trend, it related to the sport. As in adults, anterior cruciate ligament injured also lead to the same risk for knee, thus requiring the need of surgery. However, at this age, children’s bones are still developing, so the ligaments formed by the creation of the bone tunnel has the risk of cartilage injury and affecting the development of following bone. So, what should we do? What is the treatment plan like? …
The development of children’s bones based on the development of cartilage at the top of the long bones, the end of the femur and the head of the tibia. Basically, when the bones have fully developed, the image of cartilage development will not be seen on X-ray films anymore.
The importance of cartilage development is bone development, makes long and completes the bone head structure. For some reasons, the development of cartilage has an injury that may affect the development of bone leading to changes in the shape and structure: short or crooked limbs,… The most common injuries are fractures in the develop cartilage areas.
For shaping anterior cruciate ligament, forming two bone tunnels in the tibial plateau and femur in place of the original ligament grip are needed and then inserted and fixed tendon in the femoral tunnel.
Therefore, unlike adults, the ligament formed has to be considered two things: the first is shaping the ligament to prevent joint damage and creating the knee rehabilitation; the secondary is creating the tunnel and fixing ligament tunnel through the develop cartilage may affect bone development.
Furthermore, the development of youth through many different stages with different speeds, so treatment options are not the same, but depends on the development process, in which the degree of bone development has an important role. Assess the child’s development, there are many ways evaluated, including the classification of Tanner.
Some authors propose delaying surgery until the development of cartilage has completed or relatively completed, but the results are not highly successful and patients have to reduce the necessary exercises.
In case, the surgery cannot be delayed, some authors suggest that the creation of tunnel formation should avoid the cartilage, but encountered problems anatomical location of the ligaments does not get the best result. To solve this problem, some authors recommend drilling the tunnel to the smallest size as possible with no stimulating factor (button or screw fixed ligament) in place of developed cartilage.
Because of these difficulties, the anterior cruciate ligament injury in children has no a specific treatment plan. The decision whether to take a surgery or not depends on the situation of ligament injury and severity of knee loose, damage coordination, advocacy needs of the patient, mature stage of the patient, understanding the risks and the need of surgery for the patient’s family.
The bottom line, it can be quite confusing and complicated anyway. However, the lucky thing is that child’s maturity level is not high, the ligament injury is very rare, but if it does, usually sloughing of the sticking point and ligament injuries are encountered primarily in children having a high level of maturity, therefore, the choice of treatment options may seem easier.
In this article, we tried to give you some necessary information about treatment for the anterior cruciate ligament fracture in children that help you imagine the dangers of this disease and the necessary of treatment. Hope you are pleased with the article.