Due to an increase in sporting activities, the number of injuries of the immature knee is continuously increasing. These injuries necessitate a special approach regarding the particular anatomical situation with open growth plates. Three of the most commonly occurring injuries are rupture of the anterior cruciate ligament, patella dislocation and meniscus injuries. The clinical results for conservative treatment of ruptures of the anterior cruciate ligament in the growth phase are inferior to operative treatment. Transepiphyseal reconstruction has been shown to be a safe treatment method and provides good clinical results. Therapy of patella instability in children has shown poor results and new surgical techniques have been introduced to perform an anatomical reconstruction of the medial patellofemoral ligament as well as to improve distal alignment. Isolated injuries to the meniscus are rare and discoid meniscus is a special phenomenon occurring in infancy. Meniscus injuries should be treated with primary sutures rather than resection. A discoid meniscus should be resected with extreme caution and anatomically reconstructed.
