Physeal fractures about the knee.

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Abstract

Conflict of interest statement: Rhianna M. Little declares that she has no conflict of interest. Matthew D. Milewski reports personal fees from Elsevier, Inc, and grants from Pediatric Orthopaedic Society of North America outside the submitted work. Human and animal rights and informed consent This article does not contain any studies with human or animal subjects performed by any of the authors. 4. Orthop Traumatol Surg Res. 2022 Feb;108(1S):103120. doi: 10.1016/j.otsr.2021.103120. Epub 2021 Oct 18. Treatment of knee sprains in children. Choufani E(1), Pesenti S(2), Launay F(2), Jouve JL(2). Author information: (1)AP-HM, Service d'orthopédie pédiatrique, hôpital Timone-Enfants, 264, rue St-Pierre, 13005 Marseille, France; Aix-Marseille université, faculté de médecine, 27, boulevard Jean-Moulin, 13005 Marseille, France. Electronic address: elie.choufani@ap-hm.fr. (2)AP-HM, Service d'orthopédie pédiatrique, hôpital Timone-Enfants, 264, rue St-Pierre, 13005 Marseille, France; Aix-Marseille université, faculté de médecine, 27, boulevard Jean-Moulin, 13005 Marseille, France. The incidence of knee sprains in children is steadily increasing. Skeletal immaturity and anatomical features of the child's ligamentous structures explain the frequency of bone avulsions in young children. Peripheral ligament injuries are the most common and often benign. Nevertheless, associated injuries of the cruciate or patellofemoral ligament(s) are not rare and must not be missed. Age is a determining factor in diagnostic guidance. Anterior intercondylar tibial eminence fractures, otherwise known as tibial spine fractures (TSF), usually occur in young children. Ligamentous distension at the time of the accident would explain the residual laxity that can affect the prognosis of these fractures. The treatment of interstitial ruptures of the ACL follows recommendations that are becoming clearer through multicentric studies. Reparation techniques, historically rejected as ineffective, have again become topical under specific conditions with the aim of preserving the native ACL and its proprioceptive receptors, which are essential in children. ACL reconstruction techniques have made progress in children, especially with techniques adapted from adults. Preservation of growth plates remains pertinent, especially at the femur to avoid growth disorders, thus highlighting the important role paediatric orthopaedic surgeons have in the management of these knee sprains. Copyright © 2021 Elsevier Masson SAS. All rights reserved. DOI: 10.1016/j.otsr.2021.103120