ABSTRACT
BACKGROUND: This study evaluates sports ability, rotational laxity and potential growth changes in children after transphyseal ACL reconstruction with metaphyseal fixation technique, considering physis biology by placing drill holes vertically in the femoral anatomic origin in order to reduce volumetric injury to the physis. METHODS: In this retrospective trial of 42 patients data were collected. Thirty-seven were reviewed measuring rotational laxity and anteroposterior tibial translation using the Laxitester (ORTEMA Sport Protection, Markgroeningen, Germany) and the KT1000. Clinical examination was evaluated with the IKDC 2000 knee examination form. Leg axis was determined with digital photography and leg length was assessed clinically. Sports ability was assessed with questionnaires including subjective IKDC, Tegner Activity Scale, Activity Rating Scale and a questionnaire on sports and level of sports. RESULTS: Mean follow-up was 24.9months. Mean age at surgery was 13.2years in boys and 13.1years in girls. IKDC 2000 grading was A or B in 28 patients and C in nine patients. Significant increased anterior tibial translation was observed in neutral position and in external tibia rotation. No growth abnormalities were seen. Fifty-seven percent of the patients were able to participate in competitive sports at follow-up. CONCLUSION: Transphyseal ACL reconstruction with metaphyseal fixation in children with open growth plates can be done with low risk of growth changes. Return to competitive sports is possible although low rotational laxity still exists. LEVEL OF EVIDENCE: IV.
Subject(s)
Anterior Cruciate Ligament Injuries/surgery , Anterior Cruciate Ligament Reconstruction , Growth Plate , Adolescent , Age Factors , Child , Female , Humans , Knee Joint/physiopathology , Male , Range of Motion, Articular , Recovery of Function , Retrospective Studies , Return to Sport , Treatment OutcomeABSTRACT
Considering the injuries of the shoulder girdle, cases with ski-injuries admitted to the Garmisch-Partenkirchen Hospital in the past ten years were analyzed. Frequency, age structure and distribution were explored and an attempt was made to connect the mechanisms of trauma with the kind of injury, regarding particularly the ski-specific factors. In the course of the past ten years an increasing relative frequency of dislocations of the shoulder was observed. In elder patients the fractures of the proximal humerus are more frequent, whereas fractures of the clavicle are more frequent in children.
