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DESCRIPTIONKnee sprain is the violent stretching of one or more ligaments in the knee. Sprains involving two or more ligaments cause considerably more disability than single-ligament sprains. When the ligament is overstretched, it becomes tense and gives way at its weakest point, either where it attaches to bone or within the ligament itself. If the ligament pulls loose a fragment of bone, it is called a sprain-fracture. A severe sprain may lead to complete rupture of a knee ligament and total loss of function. A severe sprain requires surgery for treatment.
Appropriate health care includes physical therapy and surgery (sometimes).
SIGNS & SYMPTOMS
Severe pain at the time of injury; feeling of popping or tearing inside the child's knee; tenderness at the injury site; swelling in the knee; bruising that appears soon after injury.
CAUSES
Stress on a ligament that temporarily forces or pries the child's knee out of its normal location. Sprains occur frequently in runners, walkers, and those who jump in such sports as basketball, soccer, volleyball, skiing, and distance- or high-jumping. These athletes often accidentally land on the side of the foot.
RISK FACTORS
Contact, running and jumping sports; previous knee injury; obesity; poor muscle conditioning; inadequate protection from equipment.
PREVENTING COMPLICATIONS OR RECURRENCE
Instructions for your child: Build your strength with a conditioning program appropriate for your sport; warm up before practice or competition; tape vulnerable joints before practice or competition; wear proper protective shoes -- a twist or injury to the foot can affect the knee.
BASIC INFORMATION
MEDICAL TESTSX-rays of the child's knee, hip, and ankle to rule out fractures.
POSSIBLE COMPLICATIONSProlonged healing time if the child's usual activities are resumed too soon; proneness to repeated injury; inflammation at the ligament attachment to the bone (periostitis); prolonged disability (sometimes); an unstable or arthritic knee following repeated injury.
PROBABLE OUTCOME
If this is a first-time injury, proper care and sufficient healing time before your child resumes activity should prevent permanent disability. Ligaments have a poor blood supply, and torn ligaments require as much healing time as fractures. Average healing times are: mild sprains--2 to 6 weeks; moderate sprains--6 to 8 weeks; severe sprains -- 8 weeks to 10 months.
TREATMENT
HOME CAREYour child should use crutches with tops just below the armpits. The doctor usually applies a splint from the ankle to the groin to immobilize the sprained knee. If the doctor does not apply a cast, tape, or elastic bandage:
Continue using an ice pack on the child's knee 3 or 4 times a day. Place ice chips or cubes in a plastic bag. Wrap the bag in a moist towel and place it over the injured knee. Use for 20 minutes at a time.
Wrap the child's injured knee with an elasticized bandage.
Provide the child with whirlpool treatments, if available.
Massage gently and often to provide comfort and decrease swelling.
MEDICATION
For minor discomfort, use aspirin, acetaminophen, or ibuprofen; topical liniments and ointments.
Your doctor may prescribe stronger pain relievers; injection of a long-acting local anesthetic to reduce the child's pain; injection of a corticosteroid, such as triamcinolone, to reduce inflammation; general anesthetic for surgery or arthroscopy (See Glossary) of the knee joint.
ACTIVITY
Your child can resume normal activities gradually after clearance from your doctor.
DIET & FLUIDS
No restrictions.
REHABILITATION
Instructions for your child:
Begin daily rehabilitation exercises when the cast or supportive wrapping is no longer necessary.
Use ice massage for 10 minutes before and after exercise.
OK TO GO TO SCHOOL?Yes, when condition and sense of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of a moderate or severe knee sprain, or a mild sprain persists longer than 2 weeks.
Pain, swelling, or bruising worsens despite treatment.
Any of the following occur after casting or splinting: pain, numbness, or coldness below the cast or splint; blue, gray, or dusky toenails.
Any of the following occur after surgery, if it was required: increased pain, swelling, redness, drainage, or bleeding in the surgical area; signs of infection (headache, muscle aches, dizziness, or a general ill feeling with fever).
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
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