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- Hyperextension injury
- In children bone is weaker than ligament ➔ ACL avulsion
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- MRI to look for associated injuries
- Matthias et al. 37% a/w meniscal injuries (mostly 90% Lateral)
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- Meyer and Mckeever (like Gartland)
- Type 1 = undisplaced
- 2 = displaced with intact posterior hinge
- 3 = Posterior hinge disrupted
- Modified type 4 = Comminuted
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- 1 and 2 = if able to reduce ➔ immobilise in extension for 4 week
- Type 3 = ORIF open vs arthroscopic assisted
- Suture OR
- Screw fixation
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- Initially thought to be soft tissue interposition by anterior horn of LM and inter meniscal ligament but recent studies show that it is not
- Instead, due to anterior horn of lateral meniscus attached to same fragment, pulling in different directions).
- https://pubmed.ncbi.nlm.nih.gov/12429751/
- Lowe et al. JBJS 2002 arthroscopic observe actions after failed closed reduction