Anterior cruciate ligament injury in children is an increasingly common disease. We report a rare case of surgical treatment of a 4-year-old patient who presented with an anterior cruciate ligament tear after a high-energy trauma followed by chronic spontaneous subluxation during knee flexion and extension. An extra-articular ligamental reconstruction technique was performed and the child is clinically well 4 years after surgery. Historically, non-surgical treatment has been the main treatment option, however, the indication for surgical reconstruction is increasing as we better understand the histological characteristics of the immature skeleton.
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