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Using an iliotibial tract for patellar dislocation in children
1Pediatric Orthopaedic, National Hospital For Pediatrics, 18/879 Lathanh Road, Hanoi, Vietnam, ngocyenhung@gmail.com.
Insights
Surgical treatment for pediatric patellar dislocation, often caused by antibiotic injections, shows high success rates. Procedures like retinacular release and quadricepsplasty effectively restore knee function with no recurrences reported.
Area of Science:
- Pediatric Orthopedics
- Surgical Techniques
- Musculoskeletal Disorders
Background:
- Patellar dislocation in children can result from intramuscular antibiotic injections.
- Accurate classification of patellar dislocation is crucial for treatment planning.
Purpose of the Study:
- To evaluate the clinical and functional outcomes of surgical interventions for pediatric patellar dislocation.
- To assess the efficacy of specific surgical techniques in treating this condition.
Main Methods:
- A prospective study included 74 pediatric patients (76 knees) with patellar dislocation post-injection.
- Surgical techniques involved iliotibial tract release, lateral retinacular release, medial retinaculum tension restoration, and quadricepsplasty.
- Patients were classified using Bensahel's criteria, with pre-operative clinical and radiographic assessments.
Main Results:
- The study included 74 patients (9 males, 65 females) with 76 affected knees.
- 56 knees (73.7%) were type 1 and 20 knees (26.3%) were type 2 according to Bensahel's classification.
- Excellent results were achieved in 73.7% of cases, good results in 22.4%, and fair results in 3.9%, with no reported poor outcomes or recurrences.
Conclusions:
- Surgical management involving iliotibial tract release, lateral retinacular release, medial retinaculum tension restoration, and quadricepsplasty is highly successful.
- This surgical approach is demonstrated to be simple, safe, and effective for skeletally immature children with patellar dislocation.
Objective:
To evaluate the clinical and functional results of surgical treatment of patellar dislocation in children.
Material And Methods:
A prospective study was undertaken from January 1995 to December 2004. Patients who suffered from patellar dislocation after receiving intramuscular antibiotic injections to quadriceps were recruited. A complete history of each patient was recorded, and both a clinical and a roentgenographic examination were performed preoperatively. Patellar dislocation was classified according to Bensahel's criteria. The iliotibial tract and lateral retinacula was released to restore the tension of the medial retinaculum. Quadricepsplasty was used in all patients for full flexion of knee.
Results:
There were nine males and 65 females in this study. All 74 patients (76 knees) developed dislocation of the patella after repeated intramuscular injections of antibiotic(s) into the quadriceps muscle. Fifty-six knees (73.7%) were type 1, and 20 knees (26.3%) were type 2 (Bensahel's classification). In all, we attained excellent results in 56 knees (73.7%), good results in 17 knees (22.4%), and fair results in three knees (3.9%). There have been no poor results or recurrences so far.
Conclusion:
Use of the iliotibial tract, adequate lateral retinacular release, restoration of the tension of the medial retinaculum and associated quadricepsplasty achieved a high success rate. The technique is simple, safe and effective in skeletally immature children.
