Knee ligament injuries in children.

Clanton, Thomas O.; DeLee, Jesse C.; Sanders, Brett; Neidre, Arvo

doi:10.2106/00004623-197961080-00008

Cited by 187 publications

(74 citation statements)

References 30 publications

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“…Although clinical findings such as a posterior tibial sag and provocative physical examination maneuvers such as the posterior drawer and quadriceps-active test are hallmarks of PCL insufficiency, no physical examination maneuvers can differentiate a substance tear from an avulsion injury [6,7,11,14,20,32,34,36]. Therefore, radiographic analysis is critical for proper diagnosis and treatment.…”

Section: Discussionmentioning

confidence: 99%

“…In the pediatric population, PCL injuries are rare, likely as a result of the elasticity of the ligament [9,10,28]. Furthermore, the relative weakness of the physis and bone in comparison to the ligament more commonly results in osteochondral avulsions rather than ligamentous substance tears as seen in adults [2,6,9,13,19,21,22,[26][27][28]. However, femoral avulsions of the PCL are reported more frequently than those of the tibial insertion site in children [10,12,13,19,21,25,26,28] (Table 1), and clinicians may not be as aware of the specific history, physical examination, and radiographic findings of these tibial-sided injuries as compared with those of the femur such as the need for specific imaging.…”

Section: Introductionmentioning

confidence: 99%

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Pediatric PCL Insufficiency from Tibial Insertion Osteochondral Avulsions

Pandya

Janik

Chan

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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Posterior cruciate ligament (PCL) insertion-site osteochondral avulsions in children, particularly from the tibia, are not commonly seen by orthopaedic surgeons. Because of the rarity of these injuries, careful attention to the specific physical examination and imaging findings seen with these injuries is necessary so that the proper diagnosis can be made. Osteochondral avulsions of the PCL can be missed on plain radiographs in skeletally immature patients, and therefore magnetic resonance imaging is necessary for proper diagnosis. With this knowledge, clinicians can formulate treatment plans which can return their patients to activities while avoiding potential morbidity resulting from missed diagnoses or improper treatment. We report two rare cases of PCL insufficiency stemming from tibial insertion osteochondral avulsions. Both patients underwent subsequent open reduction and internal fixation of the avulsion using two different fixation methods (bioabsorbable anchors versus cannulated screw and washer) and have returned to full sporting activities.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pediatric PCL Insufficiency from Tibial Insertion Osteochondral Avulsions

Pandya

Janik

Chan

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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“…Few cases of avulsion of PCL from its femoral attachment in children have been published in literature. [1][2][3] Literature search in pubmed revealed only five cases of PCL avulsion from medial femoral condyle in adults. …”

Section: Discussionmentioning

confidence: 99%

A rare case of bony avulsion of posterior cruciate ligament from its femoral attachment

Mishra

Vikas

2016

Medical Journal Armed Forces India

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“…After a comprehensive search, we found 11 cases of PCL avulsion fractures of femoral origin in adolescents in the literature [6,14,15,21,27]. In contrast, only four cases of PCL avulsions of femoral origin have been reported in adults [8,17,22,23] (Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…Avulsion fracture of the PCL with a femoral origin in adults has not been reported often. We performed a comprehensive literature search and found most cases of avulsion of the PCL with femoral origin were reported in adolescents [6,14,15,19,21,27]. In contrast we found only four reported cases in adults [8,17,22,24].…”

Section: Introductionmentioning

confidence: 86%

Case Report: Osteochondral Avulsion Fracture of the Posteromedial Bundle of the PCL in Knee Hyperflexion

Chen

Shi

Jiang

2012

Clinical Orthopaedics &Amp; Related Research

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Background Injury of the PCL of the knee in adults usually results in rupture rather than avulsion fracture and avulsions usually occur at the tibial insertion. Case Description We report an avulsion of the PCL with a femoral origin in a 22-year-old man who was injured by hyperflexion of the knee and was treated with arthroscopy. There were two parts in the partial osteochondral avulsion fracture of the PCL posteromedial (PM) bundle. One part was fixed with polydioxanone suture through drill holes and the other was removed. The fracture healed after 3 months and the knee was stable. At 11 months postoperatively the patient had returned to full-time work without pain or restrictions. The Lysholm II knee score was 95 points. Physical examination showed a negative posterior drawer sign. Literature Review We identified four other reported cases of PCL femoral origin avulsion fractures in adults. The subjects were 20 to 25 years old in four of five reports, including our patient. Three of the five patients had involvement of only the lateral cortex of the medial femoral condyle whereas two other patients including our patient, had an osteochondral fracture. The mechanism of PCL avulsion seems to be similar to that of a PCL rupture. Purposes and Clinical Relevance The hyperflexion injury may result in injury of the PM bundle of the PCL. Our case and one other in the literature suggest such avulsions need not involve the entire PCL.

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Knee ligament injuries in children.

Cited by 187 publications

References 30 publications

Pediatric PCL Insufficiency from Tibial Insertion Osteochondral Avulsions

Pediatric PCL Insufficiency from Tibial Insertion Osteochondral Avulsions

A rare case of bony avulsion of posterior cruciate ligament from its femoral attachment

Case Report: Osteochondral Avulsion Fracture of the Posteromedial Bundle of the PCL in Knee Hyperflexion

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