Fractures Around the Knee in Children.

Fractures Around the Knee in Children. Instr Course Lect. 2019;68:463-472 Authors: Young EY, Shlykov MA, Hosseinzadeh P, Abzug JM, Baldwin KD, Milbrandt TA Abstract Knee injuries are common in children, but epiphyseal and physeal injuries involving the distal femur and proximal tibia are relatively rare. This can make diagnosis and evaluation of pediatric knee injuries challenging. Pediatric knee physeal injuries can also be complicated by vascular injuries with potentially devastating consequences, and thus, a heightened suspicion for these injuries is indicated. Distal femoral and proximal tibial physeal injuries can be diagnosed with plain radiographs or with advanced imaging if the initial findings are equivocal. Physeal fractures of the distal femur and proximal tibia can be managed nonsurgically if nondisplaced or surgically with cannulated screw fixation or smooth, percutaneous pin fixation. Tibial tubercle injuries can have point tenderness or an extensor lag, are diagnosed with plain radiographs, and are often managed with physeal-sparing cannulated screw fixation. These injuries have an increased risk of compartment syndrome. Tibial eminence fractures are epiphyseal avulsion injuries caused by traction from the anterior cruciate ligament. Arthroscopic and open techniques for reduction and stable fixation yield good outcomes. Patellar sleeve injuries are often misdiagnosed and may require advanced imaging for diagnosis. They...
Source: Instructional Course Lectures - Category: Orthopaedics Tags: Instr Course Lect Source Type: research