膝盖伤害

没有父母希望看到他们的运动孩子坐在侧链上，但膝盖伤害每年都会在长凳上放置数千名年轻运动员。孩子们对此并不罕见断裂那sprain, strain, or dislocate the knee joint while playing on the field or just goofing around with friends.

大多数孩子只需要几天或几个星期的休息时间来从膝盖伤害中恢复。严重的病例可能需要手术，并在孩子们再次行走之前恢复更长的恢复并回到竞争场。

膝盖如何工作

To understand how injuries happen, it helps to know how the knee works. The knee is the largest joint in the body; it provides stability and allows the legs to bend, swivel, and straighten.

这knee joint is at the ends of thefemur(thighbone) and the胫骨(shinbone); it is protected by thepatella（髌骨）。股骨和胫骨的末端和髌骨的背部被覆盖关节软骨，它充当垫子，以保持股骨，髌骨和胫骨互相研磨。在胫骨的顶部，称为额外的软骨垫meniscihelp absorb the body’s weight. Each knee has two menisci — the inside (medial) meniscus and the outside (lateral) meniscus.

这musclesaround the knee include the quadriceps, a large muscle at the front of the thigh, and the hamstring, located at the back of the thigh. The quadriceps help straighten the leg and the hamstring helps bend the knee.

一些tendons- 强大的组织电缆，将肌肉连接到骨骼 - 一起工作，帮助移动膝盖。膝盖中的肌腱是Quadriceps肌腱，髌骨肌腱和腿筋肌腱。一切都在一起，让腿部延伸。

Ligaments是强大的组织的电缆，将骨头连接到骨骼。膝盖中的四个主要韧带有助于将股骨连接到胫骨并保持膝盖稳定：

1. 内侧辅助韧带（MCL）：将股骨沿着膝盖内侧连接到胫骨。它保持膝盖的内部稳定，有助于控制膝盖的侧向运动，使其保持向内弯曲。
2. 侧侧侧韧带（LCL）：connects the femur to the tibia along the outside of the knee. It keeps the outer part of the knee stable and helps control the sideways motion of the knee, keeping it from bending outward.
3. 前十字架韧带（ACL）：connects the femur to the tibia at the center of the knee. It helps control the knee’s rotation.
4. posterior cruciate ligament (PCL):connects the femur to the tibia at the back of the knee. It helps control the knee’s backward motion.

Types of Knee Injuries

Because the knee is such a complex joint with many moving parts, knee injuries are quite common. Frequent causes of injuries are overuse (from repetitive motions, as in many sports), sudden stops or twists, or direct blows to the knee.

Common injuries among kids include:

Sprains

膝盖扭矩通常涉及损坏ACL.和/或MCL。最严重的扭伤涉及一种或多种膝盖韧带的完全泪水。膝关节扭伤的症状包括：

• a popping or snapping sound in the knee at the time of injury
• pain that seems to come from within the knee, especially with movement
• not being able to bear weight on that leg
• swelling
• the knee feels loose or unstable

菌株

一种strain happens when a child partially or completely tears a muscle or tendon. With knee strains, kids may have bruising around the knee in addition to the symptoms mentioned above for sprains.

Tendonitis

Tendonitis happens when a tendon gets irritated or inflamed. It is often caused by overuse or poor training (such as lack of strength exercises or stretching). A child with tendonitis might have pain or tenderness when walking or at rest, or when bending, extending, or lifting a leg.

Meniscal Cartilage Tears

Damage to the menisci is a very common sports injury, especially in sports where kids have sudden changes in speed or make side-to-side movements. Meniscal injuries can occur together with severe sprains, especially those involving the ACL. Meniscal injuries can cause tenderness, tightness, and swelling around the front of the knee. Sometimes fluid collects around the knee (known as effusion).

Fractures and Dislocations

骨折是一种破碎、破碎或破碎的骨头。Kids may have trouble moving the bone and are likely to have a lot of pain. Patellar dislocation happens when the patella is knocked off to the side of the knee joint, by twisting or some kind of impact. Sometimes it will go back to its normal position by itself, but usually needs to be put back in place by a doctor. Symptoms include swelling and pain in the front of the knee, an abnormal bulge on the side of the knee, and inability to walk on the leg with the affected knee.

一种rticular Cartilage Injuries

有时一小块骨头或关节cartilage softens and/or breaks off from the end of a bone, causing long-term knee pain. This is called骨孔炎isscans(OCD)。Symptoms include pain; swelling; an inability to move the joint; and stiffness, catching (“locked knee”), or popping sensations with knee movement.

chondromalacia pattellae.happens when the cartilage in the patella softens because of injury, muscle weakness, or overuse, and the patella and the thighbone may rub together. This causes pain and aching, especially when a person walks up stairs or hills.

Bursitis

一种囊is a sac filled with fluid located over a bony prominence to prevent friction. If a bursa in the knee becomes inflamed and swollen from overuse or constant friction, it can develop into a condition called bursitis. Symptoms of bursitis in the knee include warmth, tenderness, swelling, and pain on the front of the kneecap.

Osgood-Schlatter疾病

Osgood-Schlatter disease是胫骨前端的重复应力引起的痛苦障碍，其中髌骨肌腱连接到骨骼。最常见的运动员10至15岁，其症状包括低于膝关节下方的凹凸，这对触感和痛苦的活动痛苦。休息疼痛缓解。

诊断

Most knee exams involve lying down flat on a table while the doctor manipulates the knee to see how stable it is and if any part of the joint hyperextends or dislocates.

一世maging tests (like anMRI那X-ray那or CAT scan) also might be done to confirm a knee injury and determine its severity.

Treatment

任何膝盖伤害的孩子都应该尽可能地休息膝盖。

一世mmediately after the injury, apply ice to the area for 20-minute intervals to reduce swelling and use compression bandages to help stabilize the knee. Do not let the child bear weight on the knee, and elevate the leg (above the heart) on pillows or other soft objects to reduce pain and swelling.

Doctors call this method of treatment RICE:

• R.est
• 一世ce
• C临时
• E.征收

这doctor might prescribe anti-inflammatory medication if your child has severe inflammation and pain.

一种fter initial treatment, some kids may wear a knee immobilizer (a brace or a sleeve that’s wrapped around the leg to keep it from moving too much) or a cast for a few weeks while the knee heals, and might need to use crutches to get around.

如果孩子韧带或肌腱或骨折部分，更严重的膝关节伤害可能需要手术来重建膝关节。

期间关节镜检查(a minimally invasive surgical technique) surgeons make a small opening in the knee and insert an arthroscope, a tiny tube-like tool, into the joint. The arthroscope has a lighted video camera on the end that is wired to a TV screen to give the surgeon a magnified view while operating.

Most of the time, the doctor is able to fix the problem during an arthroscopy. But if the injury is too complex, the surgeon will have to switch to “open” surgery, which requires a larger incision to see the area with the naked eye.

无论儿童是否具有关节镜检查或传统的膝关节损伤的开放外科手术，恢复期将是几周到几个月。

R.ehab Therapy

Most kids who recover from a knee injury will need some sort of rehabilitation (“rehab”) therapy to help heal the knee and to:

• 恢复运动范围
• 恢复膝盖，大腿和胫骨肌肉的力量，以防止萎缩（肌肉组织的崩溃）
• 减少疼痛和肿胀
• 改善平衡
• regain functional performance for activity

大多数孩子每周三次在一个中心接受康复，每天练习他们在家里练习。加速康复程序需要更频繁的治疗，并加快恢复到4至6个月。

虽然大多数体育都是禁止的限制 - 特别是在第一处导致受伤的人 - 孩子们可以做一些可能是有趣甚至治疗的低影响的活动，如游泳，自行车骑行或受保护的跑步。与您的医生交谈，其中哪一个可能使您的孩子受益，并且在正常活动可以恢复时。

Preventing Knee Injuries

Preventing knee injuries is a lot less painful and a lot less hassle than undergoing surgery.

一世f your kids play sports, be sure they always wear appropriate protective equipment during practices and competitions. Kneepads and shin guards (as well as helmets and other protective gear) will help prevent injury. Also be sure that they wear supportive shoes that are in good condition and appropriate for the sport.

More tips for avoiding sports injuries:

• 在锻炼期间，总是确保孩子热身，冷却。
• 鼓励孩子们进行定期的力量培训，以支持肌肉，伸展或瑜伽来提高灵活性。
• 跳跃时，确保您的孩子在降落时弯曲膝盖。这取决于ACL并防止损伤。
• 如果孩子们经常削减或枢转（如足球），鼓励他们蹲在膝盖和臀部，以减少ACL损伤的可能性。
• 对于仅在竞争激烈的季节期间比在较低的体育运动，调理和培训的孩子们，即使它处于较低的强度 - 也可以帮助他们保持态度并降低受伤的机会。

审查：Alfred atanda Jr.，MD
审查日期：2012年10月