Ligament lesions of the knee joint in childhood
Ritter G, Neugebauer H. Z Kinderchir 1989 Apr;44(2):94-6. Z Kinderchir 1989 Apr;44(2):94-6
As a matter of principle, all lesions of the knee associated with haemarthrosis must be examined for internal injuries. Ligament ruptures are rare; usually, there are bony ligament tears that show up on x-ray film. Examination of ligament stability in children is useful only if the x-ray is negative and after the knee joint has been punctured under anaesthesia, and can be justified only in that case. Diagnosis is possible only by means of x-ray films taken in forced extreme joint position in two planes, with lateral comparison. Treatment of all non-dislocated ligament tears is conservative; slight dislocations can be tolerated in cruciate and capsular ligaments, since the epiphyseal cartilage is not affected. Surgery should be performed only if tears are considerably dislocated. Proximal tears of collateral ligaments are epiphyseal fractures that can be treated conservatively only if there is no dislocation; if they are dislocated, surgery is absolutely mandatory.