To categorize and analyze the incidence of the knee injuries in children admitted in Assiut University from 2022 to 2025 and to establish a data base about children less than 18 years who have knee injuries for further studies.

Knee injuries are common in children and constitute about 5 %of the injuries presenting to emergency department in 1 to 18 y age group . The presence of physis or growth plate, which is weaker compared to the adjacent ligaments make injury patterns in children different from those in adults, as the same amount of force would produce a physeal fracture or avulsion injury in children but a ligament injury in an adult.

Kraus et al. divided patients according to age to infants (younger than 1 year); pre-school aged children (1-6 years); prepubertal school-aged children (7-10 years); early adolescent patients (11-14 years); late adolescent patients (15-18 years) and a five diagnosis-related groups : extraarticular soft tissue injuries, intraarticular soft tissue injuries, patella disorders, fractures, and overload injuries. They found extraarticular soft tissue injuries were most common and fractures were rare.

Skak et al found that children with ligament injuries and physeal fractures had a median age of 12 years. No lesions of the cruciate ligaments without bony avulsion were diagnosed. the most frequent cause of injuries was falls.

The most frequent traumatic injuries reported involve the cruciate and collateral ligaments (medial collateral ligament [MCL], posterior cruciate ligament [PCL], anterior cruciate ligament [ACL], and lateral collateral ligament [LCL]), menisci, and patella. Overall, females are reported to have a higher risk of sustaining a knee injury than males. Ligament injuries ,specifically ACL injuries, are among the most devastating knee injuries for young patients. Female patients have two to eight times greater risk of sustaining an ACL injury as compared with male patients. After ACL injury, there is a significant risk of developing osteoarthritis regardless of the treatment intervention, such as ACL on surgery.

The rationale of the research is to establish a data base about children less than 18 years who have knee injuries for further studies.

research and injury pattern analysis. All imaging studies stored in PACS and the operative notes and clinical data documented will be verified to enhance data validity and completeness.

The data collection process will not be limited to basic demographic and diagnostic variables. A comprehensive data abstraction form will be developed to ensure standardized retrieval of relevant clinical presentation, radiological, and final management of the patients. The extracted data will include mechanism and date of trauma, anatomical injury characteristics, associated injuries, type of management (conservative or operative), intra-operative details when applicable, radiological findings.

2.4.5 -Research outcome measures:

1. Primary (main):

   The epidemiology (incidence and patterns) of knee injuries among children (<18 years) admitted to Assiut University Hospitals between 2022 and 2025 to establish a data base about children less than 18 years who have knee injuries for further studies .and all extracted data and radiological images will be securely entered into a password-protected, anonymized electronic database (such as Red cap) to ensure confidentiality, facilitate statistical analysis, and allow future reference by the research team in compliance with institutional ethical standards.

2. Secondary (subsidiary): none

Inclusion Criteria:

• Children admitted with knee injuries (open or closed) in Assiut University.

Exclusion Criteria:

• No

Children admitted with knee injuries (open or closed) in Assiut University.