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- Title
PEDIATRIC ACL RECONSTRUCTIONS USING TRANSPHYSEAL HAMSTRINGS.
- Authors
Haragus, H.; Prejbeanu, R.; Vermesan, D.; Damian, G.; Vermesan, S.
- Abstract
Anterior cruciate ligament (ACL) injuries are increasing in skeletally immature patients. In the adult population management is fairly standardized with surgical reconstruction using hamstrings autograft being the most common current treatment. However, for the pediatric population with open physes concern exists regarding surgical management since the distal femur and proximal tibia accounts for an important lengthening and alignment of the lower limb. For this purpose we performed a retrospective evaluation of our cohort of pediatric ACL reconstructions. 4 girls and 3 boys met the inclusion criteria out of 628 consecutive cases operated by a single surgeon over the last 5 years. The girls were 13, 14 and two 15 respectively and the boys were 15 and two 16. All were competing athletes coming from: one girl volley and three hand-ball and the boys soccer. All had subjective instability and received single bundle transphyseal primary ACL reconstruction performed by the same surgeon using quadruple hamstrings (semitendinosus and gracillis) with cortical femoral and absorbable interference screw tibial fixation. All patients had associated lesions: 5 chondral, 3 internal 2 external and one both menisci; Time from injury to surgery was on average 9.1 weeks (5 to 17). 6 out of seven were available for a final follow-up of 1.9 years. All had returned to sports at preinjury activity levels and had IKDC (international knee documentation committee) scores for excellent (A) and good (B) outcomes. No clinical and radiographic growth arrests could be identified. We conclude that single bundle transphyseal ACL reconstructions using hamstrings autografts for skeletally immature patients yields favorable outcomes. However, only small portions of estimate incidence undergo specialist evaluation and surgical treatment. Further collaborations should be encouraged to allow more pediatric patients to benefit from surgical ACL reconstruction. In addition, for such cases, exact height and Tanner skeletal maturity should be noted at the time of index surgery in order to improve retrospective evaluations.
- Subjects
HAMSTRING muscle surgery; PEDIATRIC surgery; ANTERIOR cruciate ligament injuries; SKELETAL muscle injuries; AUTOGRAFTS; RETROSPECTIVE studies
- Publication
Jurnalul Pediatrului, 2012, Vol 15, Issue 59/60, p37
- ISSN
2360-4557
- Publication type
Article