Valgus and flexion deformity after reconstruction of the anterior cruciate ligament in a skeletally immature patient

Anterior cruciate ligament reconstruction in children with open physes is still a topic of debate. We report a unique case of growth disturbance in valgus and flexion of the distal femoral epiphysis, after an ACL reconstruction in a 14.5-year-old boy. The Clocheville technique using the patellar tendon was performed. The femoral tunnel and tibial groove were both positioned above the growth plates. Eighteen months after ACL reconstruction, the patient had to be re-operated on for a valgus and flexion deformity of the femoral epiphysis. The clinical, radiological and aesthetic results were satisfactory. The angular deformity was caused by the fact that either the femoral tunnel was too close to the posterolateral femoral growth plate or an excessive eccentric traction of the graft in relation to the central point of the knee.