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- Knee trauma in children and adolescents

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Fracture assessment Information page for parents

# Knee trauma in children and adolescents

The knee of children and adolescents may be involved in sports trauma, falls, sprains or twisting episodes. In growing age some lesions are not identical to those of adults: the presence of growth plates, apophyses and different bone and ligament resistance change how the trauma presents.

[Book a visit](https://ortopediaevolutiva.com/en/locations)[Back to the paediatric injuries and fractures guide](https://ortopediaevolutiva.com/en/conditions/injuries-fractures)

## What I assess during the visit

During the visit I personally review the X-ray images together with the report and any available documentation. I assess the type of fracture, alignment and stability, the child's age and remaining growth, and any relationship with the growth plate. These elements help understand whether the current pathway is appropriate and how to plan the following check-ups.

The check-up can be useful after an injury, an X-ray or an emergency department visit.

Pain after trauma, swelling, walking difficulty, joint locking or a sense of instability always deserve adequate assessment, especially if the child plays sports.

In case of visible deformity, severe uncontrolled pain, cold or pale fingers, sensory changes, open wounds or major trauma, urgent ER care is required.

![Dott. Daniele Priano - Ortopedico Pediatrico](https://ortopediaevolutiva.com/assets/doctor-avatar-3d-B7t_C744.webp)

#### 🩺 Clinical note

In paediatric fractures it is not only about whether a bone is broken: site of the lesion, growth plate involvement, the child's age and remodelling potential all shape the follow-up plan.

## Lesions to consider

Lesions that may involve the paediatric knee include tibial spine avulsions, often related to the anterior cruciate ligament mechanism in children; osteochondral fractures involving the articular surface; meniscal lesions; apophyseal avulsions; and osteochondritis dissecans, which may present with pain, swelling or sports difficulty even without obvious trauma.

## Tibial spine avulsion

Tibial spine avulsion is a typical paediatric and adolescent lesion. It may appear after a sprain mechanism and deserves careful evaluation because it involves the tibial insertion of the anterior cruciate ligament. The pathway depends on the type of lesion, stability and the examinations performed.

## Osteochondritis dissecans and osteochondral lesions

Osteochondritis dissecans of the knee involves the subchondral bone and cartilage. It is more frequent in older children and sporting adolescents. Lesion stability, skeletal age and symptoms are important elements to define the pathway. Post-traumatic osteochondral lesions, on the other hand, may appear after sprains or patellar dislocations/subluxations.

## Possible aspects to check
- knee swelling after trauma
- persistent pain
- joint locking
- instability or giving way
- difficulty returning to sport
- suspected tibial spine avulsion
- suspected osteochondral lesion
- skeletal age and residual growth

Aspects assessed during a paediatric orthopaedic visit. They are not self-management criteria.

## Related content

[paediatric sports traumatology](https://ortopediaevolutiva.com/en/conditions/sports-injuries)[surgical treatment of paediatric fractures](https://ortopediaevolutiva.com/en/surgery/injuries-fractures)[fractures near the growth plate](https://ortopediaevolutiva.com/en/surgery/physeal-fractures)[patellar dislocation](https://ortopediaevolutiva.com/en/conditions/patellar-dislocation)[tibial spine avulsion fracture](https://ortopediaevolutiva.com/en/conditions/tibial-spine-fracture)[Back to the paediatric injuries and fractures guide](https://ortopediaevolutiva.com/en/conditions/injuries-fractures)

## Complete injuries and fractures pathway

This page is part of the paediatric injuries and fractures pathway. The main guide covers the overall picture and the warning signs.
- [1 Overview: when an injury is urgent How growing bone behaves, what happens in the emergency room and when an orthopaedic review is useful.](https://ortopediaevolutiva.com/en/conditions/injuries-fractures)
- [5 Lower limb and ankle Femur, leg, knee and ankle: weight-bearing, healing times and return to walking.](https://ortopediaevolutiva.com/en/conditions/femur-fracture-children) [Leg](https://ortopediaevolutiva.com/en/conditions/leg-fracture-children)
- [Ankle](https://ortopediaevolutiva.com/en/conditions/ankle-fracture-children)
- [Knee injury · you are here](https://ortopediaevolutiva.com/en/conditions/knee-injury-children-adolescents)
- [Tibial spine](https://ortopediaevolutiva.com/en/conditions/tibial-spine-fracture)
- [Ankle surgery](https://ortopediaevolutiva.com/en/surgery/fractures/ankle)
- [Foot surgery](https://ortopediaevolutiva.com/en/surgery/fractures/foot)
- [6 Imaging, cast and follow-up Growth plate, follow-up X-rays and management of immobilization.](https://ortopediaevolutiva.com/en/conditions/physeal-fractures)
- [7 Recovery and protocols How recovery works after injury or surgery; protocols are professional material.](https://ortopediaevolutiva.com/en/rehabilitation)

Adjacent clinical pictures: [Sports injuries](https://ortopediaevolutiva.com/en/conditions/sports-injuries)

## Paediatric orthopaedic check-up after trauma or fracture

Dr. Daniele Priano sees children and adolescents in Milan. The visit can be useful after the ER, X-rays, a cast, sports trauma or questions about the follow-up pathway.

[Book a paediatric orthopaedic check-up](https://ortopediaevolutiva.com/en/locations)[See locations and booking](https://ortopediaevolutiva.com/en/locations)

Content for general informational purposes only. It does not replace a medical evaluation.

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Canonical: https://ortopediaevolutiva.com/en/conditions/knee-injury-children-adolescents

Le informazioni cliniche sono divulgative e non sostituiscono una valutazione medica diretta.