🦵 Section 718.7 · Anterior Cruciate Ligament (ACL) Rupture

Nelson Textbook of Pediatrics 22nd Edition | ACL tears account for >50% of knee injuries. Peak incidence 16-18 years. Female athletes have up to 2-fold increased risk. Classic presentation: noncontact injury (pivoting, cutting, landing), audible 'pop', knee swelling within hours. Lachman test most sensitive. MRI confirms. Treatment: physeal-sparing reconstruction in skeletally immature; standard transphyseal in adolescents. Return to sports 9-12 months post-op. Prevention programs reduce risk (neuromuscular training).

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📋 30 Clinical Scenarios — ACL Rupture

📇 High‑Yield Review Cards

🩺 Clinical Recognition: ACL Tear

Select a presentation to review diagnostic clues and management per Nelson 718.7.

📋 Stepwise Management of ACL Rupture

🔑 Key Principles — Nelson Section 718.7
• Epidemiology: >50% of knee injuries. Peak 16-18 years. Female athletes 2x risk (neuromuscular factors → dynamic valgus).
• Mechanism: Noncontact (70%) — pivoting, cutting, landing, deceleration. Contact (30%) — valgus force.
• Examination: Lachman test (most sensitive, 70% chance ACL tear if effusion + 'pop'), anterior drawer, pivot shift (specific).
• Imaging: MRI confirms tear, assesses meniscal/chondral injury.
• Treatment: Active patients → reconstruction. Physeal-sparing techniques if open physes. Surgery within 3 months reduces meniscal injury risk.

    ⚡ Reflex Prompts — Clinical Decisions

    📖 Summary: ACL Rupture (Nelson 718.7)