[Anterior cruciate ligament rupture in children with open growth plate : Diagnostics and treatment]

Anterior cruciate ligament (ACL) ruptures in pediatric patients with open growth plate are of concern and the number of injuries is increasing. The possibilities for diagnostics using magnetic resonance imaging (MRI) have improved and are without radiation exposure to the growing skeleton. The MRI should be performed routinely in every case of adequate trauma also to recognize additional injuries to the knee joint. Joint effusion represents an urgent indication for further clarification. Real ACL ruptures have to be distinguished from bony avulsion injuries. Although there are different forms of treatment, biomechanically an ACL insufficiency is present. A permanent instability leads to degenerative changes of the cartilage and meniscus. Despite the different surgical techniques, the general recommendation is for replacement of the ACL. Extensive procedures with an increased risk of epiphyseal injury should be avoided and anatomical techniques should be preferred. The results are good to very good and with adequate knowledge of the special features of children, complications are rare.