BACKGROUND: Titanium elastic nails are commonly used to stabilize femoral fractures in school-aged children, but there have been few studies assessing the risks and benefits of this procedure compared with those of traditional traction and application of a spica cast. This prospective cohort study was designed to evaluate these two methods of treatment, with a specific focus on the first year after injury, the period when the treatment method should have the greatest impact.

METHODS: ...

BACKGROUND: Anterior cruciate ligament (ACL) reconstruction failure rates are highest in youth athletes. The role of the anterolateral ligament in rotational knee stability is of increasing interest, and several centers are exploring combined ACL and anterolateral ligament reconstruction for these young patients. Literature on the anterolateral ligament of the knee is sparse in regard to the pediatric population. A single study on specimens younger than age 5 years demonstrated the ...

BACKGROUND: Revision anterior cruciate ligament (ACL) reconstruction has been documented to have worse outcomes compared with primary ACL reconstruction.

HYPOTHESIS: Certain factors under the control of the surgeon at the time of revision surgery can both negatively and positively affect outcomes.

STUDY DESIGN: Case-control study; Level of evidence, 3.

METHODS: Patients undergoing revision ACL reconstruction were identified and prospectively enrolled between 2006 and 2011. Data collected ...

BACKGROUND: Young athletes sustain patellar dislocations in a variety of sports. The medial patellofemoral ligament (MPFL) is a critical structure that functions as an anatomic checkrein to help prevent lateral patellar dislocation. Reconstruction of this ligament is challenging in patients with open physes because of concerns about iatrogenic damage to the femoral physis.

PURPOSE: To evaluate the relationship of the distal femoral physis and the MPFL.

STUDY DESIGN: Descriptive ...

BACKGROUND: In skeletally immature patients with an anterior cruciate ligament (ACL) tear and significant growth remaining, the risk of inducing a growth disturbance with early reconstruction must be balanced against the risk of further intra-articular damage by delaying treatment until closer to skeletal maturity.

HYPOTHESIS: Increased time from injury to ACL reconstruction in children ≤14 years of age will be associated with increased meniscal and chondral injuries at the time of ...

BACKGROUND: Anterior cruciate ligament (ACL) injury rates are affected by frequency and level of competition, sex, and sport. To date, no study has sought to quantify sport-specific yearly risk for ACL tears in the high school (HS) athlete by sex and sport played.

PURPOSE: To establish evidence-based incidence and yearly risk of ACL tears in HS athletes by sex for sports performed at the varsity level across the majority of US high schools.

STUDY DESIGN: Meta-analysis.

METHODS: PubMed, ...

Although literature supports bracing of most medial collateral ligament (MCL) injuries followed by arthroscopic repair of anterior cruciate ligament (ACL) tears in adults with combined ACL-MCL injuries, little is published regarding the treatment of these injuries in the pediatric population. The purpose of this study was to present our outcomes after treatment of combined ACL-MCL injuries in a series of adolescents. All 180 patients who underwent ACL reconstruction at our children's ...

BACKGROUND: Recovery from anterior cruciate ligament reconstruction (ACLR) requires an intensive course of postoperative rehabilitation. Although guidelines outlining evidence-based rehabilitation recommendations have been published, actual practice patterns of physical therapists are unknown.

OBJECTIVES: To analyze the current landscape of clinical practice as it pertains to rehabilitation progression and the use of time and objective criteria in rehabilitation following ACLR.

METHODS: ...

BACKGROUND: Tibial eminence fractures are rare but occur more frequently in children and adolescents. There are a variety of methods to surgically treat these fractures, but surgeons disagree about the optimal method of reduction and fixation.

HYPOTHESES: Regarding clinical results and complications after treatment in children and adolescent patients with tibial eminence fractures, the authors hypothesize that (1) there is no difference between reduction and fixation with screws versus ...

BACKGROUND: Debate regarding the optimal initial treatment for anterior cruciate ligament (ACL) injuries in children and adolescents has not resulted in a clear consensus for initial nonoperative treatment or operative reconstruction.

HYPOTHESIS/PURPOSE: The purpose of this meta-analysis was to systematically analyze aggregated data from the literature to determine if a benefit exists for either nonoperative or early operative treatment for ACL injuries in the pediatric patient. The ...

BACKGROUND: The occurrence of physiologic knee hyperextension (HE) in the revision anterior cruciate ligament reconstruction (ACLR) population and its effect on outcomes have yet to be reported. Hypothesis/Purpose: The prevalence of knee HE in revision ACLR and its effect on 2-year outcome were studied with the hypothesis that preoperative physiologic knee HE ≥5° is a risk factor for anterior cruciate ligament (ACL) graft rupture.

STUDY DESIGN: Cohort study; Level of evidence, ...

BACKGROUND: The optimal treatment of osteochondritis dissecans (OCD) of the capitellum in adolescent athletes remains challenging. The purpose of this study was to investigate the mid-term results of arthroscopic treatment of OCD of the capitellum in a series of adolescents.

METHODS: We identified 25 consecutive patients at our institution that underwent arthroscopic treatment for OCD of the capitellum since 1999. Ten elbows were treated by arthroscopic debridement and drilling alone, ...

BACKGROUND: All-epiphyseal anterior cruciate ligament (ACL) reconstruction is a well-described technique for skeletally immature patients. The purpose of this study was to elucidate the early complication rate and identify associated risk factors for rerupture after this procedure in children.

METHODS: We retrospectively reviewed patients who underwent all-epiphyseal ACL reconstructions performed at a large, tertiary care children's hospital between January 2007 and April 2013. Relevant ...

BACKGROUND: Understanding the relationship of the posterior cruciate ligament (PCL) and the lateral collateral ligament (LCL) to the femoral and tibial physes is important to reducing the risk of physeal injury during surgical reconstruction. The purpose of this study was to identify the location of the attachments of the PCL and LCL in skeletally immature cadaveric knee specimens and to determine their position relative to the physes.

METHODS: Seven skeletally immature cadaveric knee ...

BACKGROUND: The optimal treatment of medial epicondyle fractures in pediatric athletes remains unclear.

PURPOSE: To evaluate the outcomes of operative and nonoperative management of medial epicondyle fractures in young athletes.

STUDY DESIGN: Case series; Level of evidence, 4.

METHODS: The records of all children with fractures of the medial epicondyle over a 5-year period, with a minimum 2 years of follow-up at a pediatric tertiary referral center, were reviewed. Patients with ...