Forms of cruciate ligament rupture in children

In general, anterior cruciate ligament ruptures can be divided into three forms. The complete tear, the tear or partial tear with overstretching of the outer ligament structures and the tear with bone involvement. Complete tear (complete rupture): In this case, the cruciate ligament is completely torn, the continuity is completely interrupted.

Likewise, there is no longer a ligament connection between the thigh and the tibia, and the stability of the knee joint can no longer be maintained. The lower part of the torn ligament no longer grows together with the upper part by itself, because it sinks downwards due to gravity. Tear (partial rupture): With this type of injury, only the inner parts of the ligament are affected; the “shell” remains intact, but is often overstretched due to the injury pattern.

Nevertheless, the stability of the joint cannot be maintained properly. If the inner part of the ligament remains connected, there is also a chance of self-healing. Tearing of the bony connection: If the anterior cruciate ligament in children is torn, it is not uncommon for part of the bony structure to be torn out as child bones are still relatively soft.

The affected bone is often the shin bone (tibia), since the femur is much thicker. A piece of bone is missing at the upper end of the tibia, the ligament itself is still intact or torn. If bony structures are involved, self-healing is just as impossible as in the case of a complete tear, since the bone pieces are also no longer connected to each other and can therefore no longer grow together.

A torn ligament causes various symptoms. The first signs of a rupture of the anterior cruciate ligament can often be noticed during the development of the injury. Loud cracking, tearing or even banging, as well as sudden severe pain during clumsy movement of the child, indicate involvement of the ligaments.

Immediately afterwards, swelling and pulling pain in the joint quickly become noticeable. If the joint turns blue or reddish, this indicates a spreading bruise in the joint. This is caused by blood vessels in the vicinity of the ligament, which were also damaged due to the injury.

However, the bruise can also only appear after some time (minutes to hours). If blood accumulates in the joint, the skin above the knee is tight and shiny, and the knee feels hot. Since the cruciate ligaments, especially the anterior cruciate ligament, normally stabilize the knee joint and restrict mobility, instability or abnormal mobility can be observed in the event of a torn cruciate ligament.

When the leg is bent, the tibia can be moved unnaturally far forward against the thigh. If, in addition to the anterior cruciate ligament, the inner ligament is also involved, a lateral displacement of the two bones against each other can also be observed. If the little patients try to stand up or walk, they often bend in again, a limping gait to relieve the damaged knee is typical.

In addition, the children complain of pain when they move or touch. Another typical symptom of torn ligaments is that the pain subsides after a short time at rest, but increases again under stress. The pain is characterized as dull and throbbing at rest, and as stabbing or pulling under stress.