The extent of the ACL injury is an important determinant of which children can be considered for nonoperative management. In a tibial spine avulsion injury, the fracture of the intercondylar…

Risk factors such as family history and younger age at first dislocation have been associated with recurrent instability. As expected, abnormal anatomy including patellofemoral malalignment as measured by increased Q…

Any loose, fibrillated, or unstable full-thickness articular cartilage defect should be removed from the bed of the lesion using a curette, ring curette, and motorized shaver (Fig. 26.2). Take care…

TREATMENT Skeletally immature patients with patellar dislocations require a thorough evaluation to understand the role that various factors play in their presentation. Medial patellar tendon transfer has been generally used…

Some may choose to get additional diagnostic studies such as a computed tomography (CT) scan, which has been shown to have some use in better defining fracture characteristics as well…

The varus and valgus moments generated at the knee can be even more substantial during sporting activities such as running, side-stepping, and cutting6 and can serve as a predictor of…

The growth plate of the distal femur provides more to the longitudinal growth of the lower limb than any other growth plate, and the physis of the proximal tibia is…

DISTAL FEMUR FRACTURES Distal femoral physeal fractures in children may be difficult to treat and are associated with a high rate of complications including growth arrest.1 Close follow-up is necessary…

Step 1: Graft Harvest Hamstring autograft is the graft choice in this skeletally immature population. A 2-cm vertical incision over the distal insertion of the hamstring tendon is the preferred…