Operative Treatment of Chronic Pediatric Patellar Instability

IF 0.2 Q4 ORTHOPEDICS
Peter Staunton , Alan Katz , Thierry Pauyo
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引用次数: 0

Abstract

Chronic patellar instability in the pediatric population presents early in life and can present as a permanent irreducible dislocation or a habitual dislocation with knee flexion. Congenital patellar dislocation tends to present at birth, with a knee flexion contracture, valgus malalignment of the lower limb and external tibial torsion. Habitual dislocation may present later. The pathoanatomy of congenital and habitual dislocation differentiate. Accurate diagnosis of the underlying pathology is important as the operative management of these conditions is based on addressing these underlying pathologies and so a thorough history and clinical exam is vital. Plain radiographs generally provide the information required to make a diagnosis and plan operatively. Nonoperative management tends to lead to poor long-term outcomes but there is poor consensus in the literature regarding the operative treatment of these conditions. The evaluation and operative treatment of these conditions is described in detail here, addressing the extensor mechanism rotation or attachment abnormalities, the lateral position of the patellar tendon insertion and the laxity of the medial soft tissues.

小儿慢性髌骨不稳的手术治疗
小儿慢性髌骨不稳在生命早期就会出现,可表现为永久性不可复位脱位或膝关节屈曲时的习惯性脱位。先天性髌骨脱位多在出生时出现,伴有膝关节屈曲挛缩、下肢外翻错位和胫骨外翻。习惯性脱位可能在以后出现。先天性脱位和习惯性脱位的病理解剖有所不同。对潜在病理的准确诊断非常重要,因为这些病症的手术治疗是以解决这些潜在病理为基础的,因此详尽的病史和临床检查至关重要。X光平片通常可提供诊断和手术计划所需的信息。非手术治疗往往会导致不良的长期疗效,但文献中对这些病症的手术治疗并没有达成共识。本文详细介绍了这些病症的评估和手术治疗方法,涉及伸肌机制旋转或附着异常、髌腱插入的外侧位置以及内侧软组织松弛。
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来源期刊
CiteScore
0.40
自引率
0.00%
发文量
40
审稿时长
83 days
期刊介绍: Operative Techniques in Orthopaedics is an innovative, richly illustrated resource that keeps practitioners informed of significant advances in all areas of surgical management. Each issue of this atlas-style journal explores a single topic, often offering alternate approaches to the same procedure. Its current, definitive information keeps readers in the forefront of their specialty.
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