Clinical outcome of avulsion fracture of the anterior cruciate ligament between children and adults.

Abstract

The aim of this study was to compare clinical and radiological results after surgical treatments of anterior cruciate ligament (ACL) avulsion fractures in children and adults. Forty cases (18 children, 22 adults), who underwent surgical treatment for an avulsion fracture of the ACL and followed up for more than 1 year, were enrolled in this study. Fractures were classified using modified Meyers and McKeever criteria. We compared the two groups with regard to range of motion, Lysholm Knee (LK) scores, the Lachman test and the Pivot-shift test, and instrumented anterior laxity determined using an arthrometer. Types of fracture in children were categorized as eight cases of type II, 10 of type III; and in adults as two cases of type II, 15 of type III, and five of type IV. A higher incidence of type IV fracture was encountered in the adult group. Adults had higher incidences of accompanied meniscal injuries and type IV fractures than children. Significant differences were found in mean LK scores, 99.3 points in children and 89.5 in adults (P<0.05). However, no significant differences were found between adults and children in terms of range of motion, the Lachman test and the Pivot-shift test, and instrumented anterior laxity. LK scores of ACL avulsion fracture were better in children than in adults. Possible causes of these results are higher incidences of accompanying meniscal injury and type IV fracture in adults. However, no intergroup differences were found in terms of stabilities.