Arthroscopy & ACL avulsion suture fixation in a child Ahmedabad India Dr Nishith Shah

Anterior cruciate (ACL) & Posterior cruciate ligament (PCL)injuries are becoming more common in children & adolescent because of sports injuries like football, basketball, road traffic accidents in males or household injuries in females.

In children and adolescents, bony avulsion of ACL from tibia ( leg bone) is seen many times. Depending on degree of avulsion, surgery is performed. One need not have MRI study to see this injury. Excellent quality digital x rays can easily clinch diagnosis of ACL avulsion injury. Totally displaced fragment or open book type avulsions must be fixed ASAP. It is not only a fracture, but most imp. ligaments of a knee joint- ACL or PCL are attached to this fragment. If this is not properly addressed early arthritis with meniscus injury & cartilage damage is inevitable. These children will have repeated swelling ( synovitis) & effusion ( excessive water) of affected knee joint.

Avulsion injury can be fixed by many methods. Sutures. screw, tension band wiring etc.Here we have demonstrated arthroscopic suture technique that is simple to perform, is economical, producing minimal damage to the growth plate ( epiphyses) & has given excellent long term results.With porper pre operative palnning and perfect surgery, normal knee function can be restored in children even after ACL or PCL avulsion.

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