Clinical examination and investigation of the cruciate ligaments in children with fibular hemimelia

In this retrospective study of abnormalities of the cruciate ligaments in children with fibular hemimelia, 69 knees were clinically examined, of which 20 were further investigated by means of arthroscopy or nuclear magnetic resonance imaging (NMRI) for objective evidence of ligament lesions. The study allowed the type and incidence of cruciate ligament abnormalities found in this condition to be determined. The anterior cruciate ligament was affected (aplasia or hypoplasia) in 95% of cases and the posterior cruciate ligament in 60%. Although these lesions only rarely have functional consequences in such patients, pretreatment assessment should nevertheless include an active search for their presence to avoid subluxation of the knee during femoral lengthening, should this be the chosen approach.