The Results of Adductor Magnus Tenodesis in Adolescents with Recurrent Patellar Dislocation

Recurrent dislocation of the patella is a common orthopaedic problem which occurs in about 44% of cases after first-time dislocation. In most cases of first-time patellar dislocation, the medial patellofemoral ligament (MPFL) becomes damaged. Between 2010 and 2012, 33 children and adolescents (39 knees) with recurrent patellar dislocation were treated with MPFL reconstruction using the adductor magnus tendon. The aim of our study is to assess the effectiveness of this surgical procedure. The outcomes were evaluated functionally (Lysholm knee scale, the Kujala Anterior Knee Pain Scale, and isokinetic examination) and radiographically (Caton index, sulcus angle, congruence angle, and patellofemoral angle). Four patients demonstrated redislocation with MPFL graft failure, despite the fact that patellar tracking was found to be normal before the injury, and the patients had not reported any symptoms. Statistically significant improvements in Lysholm and Kujala scales, in patellofemoral and congruence angle, were seen (P<0.001). A statistically significant improvement in the peak torque of the quadriceps muscle and flexor was observed for 60°/sec and 180°/sec angular velocities (P=0.01). Our results confirm the efficacy of MPFL reconstruction using the adductor magnus tendon in children and adolescents with recurrent patellar dislocation

Lower limb equalization with percutaneus epiphysiodesis of the knee joint area.

IntroductionEpiphysiodesis has become one of the most popular methods in the treatment of leg length discrepancy (LLD) due to its surgical simplicity, short hospitalization time, and a low risk of complications.Patients and MethodsA retrospective analysis was performed on 34 patients treated for LDD with percutaneus epiphisiodesis of the distal femur and/or the proximal tibia. The mean discrepancy was 2.8 cm. The outcome evaluation method was based on Kemnitz et al.ResultsBased on the Kemnitz criteria, 23 (67.6%) patients experienced good results, while 2 (5.9%) satisfactory and 9 (26.5%) poor results. In 47% of patients, swellings of the knee joint were observed in the postoperative period. One serious complication - varus deformity of 10 degrees in femur occurred in the follow-up period.ConclusionsPercutaneous epiphysiodesis is a simple method of the LLD correction, with a low rate of complications and applicable in cases of late LDD diagnosis

Clinical and radiological evaluation of surgical treatment of medial epicondyle fractures of humerus in children. A two-centre study

Abstract The present study analyses the outcome of open reduction and internal fixation (ORIF) of humerus medial epicondyle fracture with the use of Kirschner (K) wires, and determine the effect of elbow dislocation. The study included 112 patients operated on in 2005–2016. Of these, 81presented with an isolated medial epicondyle fracture (mean age 11.6 years), and 31 with an elbow dislocation (mean age 11.9 years). Out of 112 patients tested, 98 achieved an excellent treatment result, ten good and a mean Mayo Elbow Performance Score (MEPS); no significant differences were observed between dislocated and non-dislocated elbow groups. Those with an isolated medial epicondyle fracture demonstrated a mean flexion of 140.7° and extension deficit of 3.0°, while those with an elbow dislocation displayed a mean flexion of 134.5° and extension deficit 6.1°. The dislocation group demonstrated significantly greater extension and flexion deficits (p = 0.019, p < 0.001, respectively). One patient required revision surgery due to nonunion. Ulnar nerve function was normal in 110 patients: in the other two, it resolved spontaneously in one, and the nerve was transposed in the other. Medial elbow instability was found in seven patients: two with elbow dislocation and five without. ORIF with K wires is a safe procedure for treating medial epicondyle humeral fractures that yields good or very good results. Similar outcomes are observed between patients with and without dislocation according to MEPS; however, flexion and extension are more limited in the former group