Nine children who were less than fourteen years old and had open physes
and ligament injuries of the knee were studied. Despite an initial thorough
physical and roentgenographic evaluation, the full extent of the lesion was
determined only at operation in seven of the nine patients. The
intercondylar eminence of the tibia was avulsed in five patients, four of
whom had associated collateral ligament injuries and a positive anterior
drawer sign. Despite surgical repair, all nine patients demonstrated some
degree of postoperative ligament instability. This was increased in those
patients in whom menisectomy had been performed concomitantly with ligament
repair. Although none of the children were symptomatic at the time of
writing, development of degenerative arthritis in the future must be
considered. Ligament injury must be considered in the differential
diagnosis of the child suffering from knee trauma. The association of
avulsion of the tibial spine and collateral ligament injury is
emphasized.