Congenital Deformity of the Knee Joint: A Boy With Congenital Patella Alta

ntroduction: Patella alta is an extremely rare condition, refers to an abnormally high position of the patella. Surgical treatment of habitual dislocation of the patella aims at a step-by-step correction of the abnormality. Case Presentation: A 4-year-old boy presented with a rare superior dislocation of the patella. Clinical examination and radiographs confirmed the dislocation of the patella. The patella was reduced with proper reduction technique under sedation, resulting in the improvement of active range of motion. onclusion: Congenital patella alta is a rare deformity in children. Treatment and diagnosis in the early stages are of our priority in the treatment. Our non-surgical treatment is our preferred treatment in this patient. The surgical treatment approach is performed in patients that have no response to non-surgical treatments.

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Latero-distal transposition of the tibial crest in cases of medial patellar luxation with patella alta

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-11-07-0108 ◽

2012 ◽

Vol 25 (04) ◽

pp. 281-285 ◽

Cited By ~ 9

Author(s):

U. Segal ◽

M. Or ◽

J. Shani

Keyword(s):

Surgical Treatment ◽

Postoperative Complications ◽

Clinical Outcomes ◽

Surgical Procedure ◽

Patella Alta ◽

Trochlear Groove ◽

Proper Position ◽

Anatomical Position ◽

Surgical Treatments ◽

Anatomical Alignment

SummaryMedial patellar luxation is defined as medial displacement of the patella from the trochlear groove. In dogs, medial luxations account for 75% of all patellar luxation cases, and are frequently associated with patella alta. Common surgical treatments for medial luxation are trochleoplasty and lateral transposition of the crest to drive the patella into the correct anatomical alignment. Postoperative complications for this procedure are estimated to be between 18–29% of cases, with up to 48% of complications involving reluxation. It was previously hypothesized that in cases of medial luxation involving patella alta, the addition of a distal component to the lateral tibial crest transposition will result in repositioning of the patella into its proper position in the trochlear groove, thus reducing the recurrence of luxation. We performed this modified procedure on 14 dogs (17 limbs) that were suffering from medial luxation combined with patella alta, and our results led to favourable clinical outcomes. This modified surgical procedure places the patella into a more normal proximodistal anatomical position, is simple to perform, and may become common practice for surgical treatment of medial patellar luxation with an alta component.

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Superior Patellar Dislocation Misdiagnosed as Patellar Tendon Rupture: The Value of Ultrasonography

Case Reports in Orthopedics ◽

10.1155/2016/2037381 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Artit Boonrod ◽

Sermsak Sumanont ◽

Manusak Boonard ◽

Arunnit Boonrod

Keyword(s):

Emergency Department ◽

Patellar Tendon ◽

Patellar Dislocation ◽

Tendon Rupture ◽

Rare Condition ◽

Plain Radiography ◽

Patellar Tendon Rupture ◽

Different Types ◽

Superior Dislocation ◽

Dislocation Of The Patella

Superior dislocation of the patella with intact patellar tendon is a rare condition. Most cases in literatures were diagnosed by clinical examination and plain radiography; however there are many cases that were misdiagnosed as patellar tendon rupture. In this case, we demonstrate the use of ultrasound for diagnosis of superior dislocation of the patella in the emergency department. We also include a literature review of similar cases and discuss the advantages of different types of imaging for diagnosis in this condition.

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Congenital Dislocation of the Patella – Surgical Treatment Rationale and Literature Review

Journal of Orthopaedic Case Reports ◽

10.13107/jocr.2021.v11.i04.2154 ◽

2021 ◽

Vol 11 (4) ◽

Author(s):

Luisella Pedrotti ◽

Barbara Bertani ◽

Federica De Rosa ◽

Federica Fossati ◽

Margherita Ghilotti ◽

...

Keyword(s):

Surgical Treatment ◽

Joint Stiffness ◽

Rare Condition ◽

Quadriceps Muscle ◽

Knee Extension ◽

Clinical Findings ◽

Surgical Correction ◽

Trochlear Groove ◽

Congenital Dislocation ◽

Dislocation Of The Patella

Introduction: Congenital dislocation of the patella (CDP) is a rare condition and its treatment is not well defined. In CDP, patella is dislocated on the lateral aspect of the distal femur, laterally from the trochlear groove, it cannot be reduced manually and it is almost always associated with genu valgum, lateral torsion of the proximal tibia, and flexion contracture of the knee. This condition is present at birth, but the clinical findings can be subtle at birth due to the size and character of the structures being examined; early diagnosis is essential, but it may be delayed to late childhood or adulthood. If CDP is not promptly treated, the disability increases during growth, so surgical correction should be planned as soon as the diagnosis is confirmed. Case Report: We report a case of bilateral CDP associated with bilateral proximal radioulnar joint stiffness; the patient at the age of diagnosis was 11 years old and underwent a bilateral delayed surgical procedure; the 4-year follow-up results are satisfactory. Surgical treatment rationale and literature are reviewed. Conclusion: Surgical correction for CDP is generally recommended, but there is no agreement in literature on the ideal treatment and in some cases, with mild impairment of the knee function, observation alone has been suggested. The decision about a surgical treatment can be difficult and depends on the degree of disability of the patient. Keywords: Congenital dislocation of the patella, bilateral congenital dislocation, patella, Z-plasty quadriceps muscle, lateral retinaculum release, lack of active knee extension.

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Superior Dislocation of the Patella Treated by Closed Reduction: A Rare Case Report and Review of the Literature

Hong Kong Journal of Emergency Medicine ◽

10.1177/102490790701400406 ◽

2007 ◽

Vol 14 (4) ◽

pp. 225-227 ◽

Cited By ~ 3

Author(s):

R Lai ◽

YK Lau

Keyword(s):

Closed Reduction ◽

Rare Condition ◽

Review Of The Literature ◽

Range Of Movement ◽

Full Extension ◽

Rare Case Report ◽

Superior Dislocation ◽

Knee Problem ◽

Dislocation Of The Patella

Superior dislocation of the patella is a rare condition. We report a 70-year-old gentleman with his patella lower pole osteophyte interlocked with the anterior femoral condyles after hyperextension. The patella was reduced successfully with proper reduction technique under sedation. The active range of movement ranged from full extension to 120-degree flexion a few minutes after reduction. He walked unaided afterwards. There was no knee problem in two years of follow-up. On reviewing the literature, only 20 cases were reported till year 2007 worldwide and 19 cases could be treated by closed reduction with or without sedation.

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Use of torso orthoses in the treatment of congenital spinal deformities: A literature review

Pediatric Traumatology Orthopaedics and Reconstructive Surgery ◽

10.17816/ptors60345 ◽

2021 ◽

Vol 9 (2) ◽

pp. 235-244

Author(s):

Ignatij А. Redchenko ◽

Sergei V. Vissarionov ◽

Maxim G. Gusev ◽

Grigoriy A. Lein ◽

Ivan V. Pavlov

Keyword(s):

Surgical Treatment ◽

Congenital Malformations ◽

Congenital Scoliosis ◽

Metal Structure ◽

Congenital Deformity ◽

Spinal Deformities ◽

Complex Treatment ◽

Clear Trend ◽

Keywords And Phrases ◽

Significant Correction

BACKGROUND: Congenital malformations of the spine require urgent treatment, despite the popularity of this problem. The choice of the term and method of surgical treatment of congenital spinal deformities with vertebral malformations does not have diametrically opposed views in the domestic and foreign literature, but the scientific discussion continues regarding the use of orthotics. Currently, several designs of orthoses on the trunk are known worldwide, which can be used not only for idiopathic but also for congenital scoliosis. А unified view of the use of this type of complex treatment is necessary, but there are opposite opinions in the scientific literature. AIM: This study aimed to analyze publications that present the use of torso orthoses in the treatment of congenital malformations of the spine. MATERIALS AND METHODS: We searched for data in the open electronic databases of PubMed and e-LIBRARY using the following keywords and phrases: congenital deformity of the spine, congenital scoliosis, orthosis, and effectiveness of orthosis. The search covered 30 years of literature. RESULTS: Several authors have reported a significant correction of the congenital curves using orthotics, but this issue has not been sufficiently studied and is still at the research stage. Some specialists consider the formation or progression after the operation of compensatory counter-curve above or below the established metal structure, which can be corrected not only by repeated surgery, but also by using orthoses. CONCLUSIONS: There is a clear trend toward complex treatment of children with isolated congenital malformations of the spine, including a reasonable combination of surgical treatment and orthotics. In Europe and Russia, preference is given to the Rigo system Cheneau brace.

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Comparative analysis of the quality of life of children with congenital scoliosis after surgical treatment: Extirpation of the hemivertebra from dorsal and combined access

Pediatric Traumatology Orthopaedics and Reconstructive Surgery ◽

10.17816/ptors60339 ◽

2021 ◽

Vol 9 (2) ◽

pp. 153-162

Author(s):

Dmitry N. Kokushin ◽

Michael A. Khardikov ◽

Sergey V. Vissarionov ◽

Vera V. Sokolova ◽

Nikita O. Khusainov ◽

...

Keyword(s):

Quality Of Life ◽

Surgical Treatment ◽

Postoperative Period ◽

Deformity Correction ◽

Lumbar Vertebra ◽

Congenital Scoliosis ◽

Congenital Deformity ◽

Subsequent Increase ◽

Level Of Satisfaction

BACKGROUND: Congenital scoliosis with disorders of the formation of the vertebrae is the most common cause of pronounced deformities of the spine in early childhood. This pathology can be treated surgically using various techniques that differ in invasiveness, severity of the condition in the postoperative period, achieved result of deformity correction, and nature of the long-term prognosis. Numerous studies have assessed the quality of life of patients who underwent surgery for acquired deformities, trauma, and degenerative and neoplastic diseases of the spine in adults. However, features of the childs quality of life following surgical technique for congenital scoliosis have not been sufficiently studied. AIM: This study aimed to compare the quality of life of children with congenital scoliosis of the thoracolumbar localization after extirpation of the hemivertebra from the dorsal and combined approaches. MATERIALS AND METHODS: An intergroup prospective analysis of the results of a survey of 60 patients with congenital deformity of the spine against the background of an isolated violation of the formation of the thoracic or lumbar vertebra was carried out. Patients underwent standard surgical treatment. Patients were divided into two groups according to the surgical approach to the abnormal vertebral body: dorsal group (n = 28) and combined group (n = 32). The average age of the patients was 75 (minmax, 26196) months. The follow-up period was 18 months after surgery. To assess the quality of life, a specialized Russian version of the PedsQL v4.0 questionnaire and a modified visual analog scale were used. RESULTS: After surgical treatment of congenital spinal deformity, quality of life indicators decreased more than two times than the results of a preoperative survey. At 18 months postoperatively, the physical activity and psychoemotional state were restored to the preoperative level, while patients of the combined group had a higher satisfaction score on the quality of life (p 0.05). CONCLUSIONS: The combined approach provides the best correction of congenital deformity of the spine and allows maintaining of the achieved result throughout the observation period. In the early postoperative period, the combined group demonstrated a significant decrease in the level of satisfaction with the quality of life, while the pain syndrome was higher than that in the dorsal group. Dynamic observation revealed the leveling of these differences and a subsequent increase in the level of satisfaction with the quality of life of these patients.

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Secondary venous aneurysm following intravenous drug abuse: A case report

Vojnosanitetski pregled ◽

10.2298/vsp140617026m ◽

2016 ◽

Vol 73 (5) ◽

pp. 500-503 ◽

Cited By ~ 1

Author(s):

Miroslav Markovic ◽

Marko Dragas ◽

Igor Koncar ◽

Igor Banzic ◽

Sinisa Pejkic ◽

...

Keyword(s):

Case Report ◽

Surgical Treatment ◽

Saphenous Vein ◽

Great Saphenous Vein ◽

Drug Application ◽

Rare Condition ◽

Intravenous Drug ◽

Venous Aneurysm ◽

General Surgeon ◽

Venous Flow

Introduction. Venous aneurysm (VA) is a rare condition that can be presented in both superficial and deep venous system. Secondary VAs as well as pseudoaneurysms are usually caused by external spontaneous or iatrogenic trauma. They are often misdiagnosed and inadequately treated. Complications include thrombosis, phlebitis, eventual pulmonary embolism and rupture. Case report. We presented a case of secondary VA of the great saphenous vein developed in a young addict following chronic intravenous drug application in the groin region. Aneurysm required urgent surgical treatment due to bleeding complication as it was previously misdiagnosed for hematoma (or abscess) and punctuated by a general surgeon. Complete resection of VA with successful preservation of continuity of the great saphenous vein was performed. Postoperative course was uneventful. Regular venous flow through the great saphenous vein was confirmed on control ultrasound examination. Conclusion. VAs are uncommon, among them secondary VA being extremely rare. In cases with a significant diameter or threatening complications surgical treatment is recommended.

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Superior mesenteric artery syndrome

International Surgery Journal ◽

10.18203/2349-2902.isj20170881 ◽

2017 ◽

Vol 4 (3) ◽

pp. 1141

Author(s):

Vikrant Mohan Bhagvat ◽

Juily Vishwanath Aher ◽

Nimesh Shah

Keyword(s):

Surgical Treatment ◽

Superior Mesenteric Artery ◽

Mesenteric Artery ◽

Rare Condition ◽

Superior Mesenteric Artery Syndrome ◽

Rapid Loss ◽

Outflow Obstruction ◽

Loss Of Weight ◽

Transverse Portion

Superior mesenteric artery syndrome (SMAS) is a rare condition caused by compression of the transverse portion of the duodenum between the superior mesenteric artery (SMA) and the aorta, causing symptoms of duodenal outflow obstruction. We report a case of superior mesenteric artery syndrome in a 25-year-old female associated with rapid loss of weight and intermittent vomiting and resulting in severe duodenal compression that necessitated surgical treatment.

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Mid-term Outcome Of Surgical Treatment In Pediatric Patients With Ebstein's Anomaly: A Single-center Cohort Study.

10.21203/rs.3.rs-42297/v1 ◽

2020 ◽

Author(s):

Jia-chen Li ◽

Xian-chao Jiang ◽

Si-meng Zhang ◽

Jin-yang Liu ◽

Ya-juan Zhang ◽

...

Keyword(s):

Surgical Treatment ◽

Reoperation Rate ◽

Term Effect ◽

Ebstein’S Anomaly ◽

Biventricular Repair ◽

Ebstein's Anomaly ◽

Long Term Follow Up ◽

Surgical Treatments

Abstract Background: Ebstein’s anomaly is a malformation of the tricuspid valve and myopathy of the right ventricle. Surgery is now the main treatment for the defect. To summarize our surgical results and experience based on patients with Ebstein’s anomaly who were under 7 years of age and treated with different surgical treatments.Materials and Methods: From January 2010 to December 2019, 80 patients under 7 years old who were diagnosed of Ebstein’s anomaly and underwent different surgical treatments were consecutively enrolled and followed up in detail. Results: The median age of the 80 patients at the time of surgery was 3.63 years. Sixty-four (80.00%) patients underwent biventricular repair while 13 (16.25%) underwent 1.5-ventricle repair. With the median follow-up 27.50 months, the long-term survival of the total cohort, 1.5-ventricular repair and biventricular repair was 82.35%, 91.67% and 100%, respectively. The long-term freedom from reoperation rate was 97.50%, 92.31% and 98.44%, respectively. Mild, moderate and severe TR before surgery occurred in 6 (7.50%), 18 (22.50%) and 56 (70.00%), respectively. The early outcomes of 78 patients were 65 (83.33%), 11 (14.11%) and 2 (2.56%); the mid-term outcomes of 72 patients were 49 (68.06%), 19 (26.38%) and 4 (5.56%). Both early and long-term valve regurgitation were significantly decreased (p< 0.001) compared with preoperative condition. No more severe regurgitation occurred (p=0.404), though some early mild regurgitation became acceptable moderate regurgitation during long-term follow-up (p=0.036). Compared with Carpentier procedure, cone procedure had better long-term effect, while the effect of whole-valve technique needed more operation and long-term follow-up.Conclusion: The reoperation rate and mid-term mortality of surgical treatment for Ebstein’s anomaly were both low, tricuspid regurgitation was significantly improved during mid-term follow up. Cone procedure had the best mid-term effect among anatomic repair.

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Surgery for vertigo: 10-year audit from a contemporary vertigo clinic

The Journal of Laryngology & Otology ◽

10.1017/s0022215115002935 ◽

2015 ◽

Vol 129 (12) ◽

pp. 1182-1187 ◽

Cited By ~ 1

Author(s):

U Patnaik ◽

A Srivastava ◽

K Sikka ◽

A Thakar

Keyword(s):

Surgical Treatment ◽

Neck Surgery ◽

Vestibular Nerve ◽

Fistula Repair ◽

Long Term Outcomes ◽

Nerve Section ◽

Perilymphatic Fistula ◽

Disease Modifying ◽

Surgical Treatments

AbstractObjective:To present the profile of patients undergoing surgical treatment for vertigo at a contemporary institutional vertigo clinic.Study design:A retrospective analysis of clinical charts.Methods:The charts of 1060 patients, referred to an institutional vertigo clinic from January 2003 to December 2012, were studied. The clinical profile and long-term outcomes of patients who underwent surgery were analysed.Results:Of 1060 patients, 12 (1.13 per cent) were managed surgically. Of these, disease-modifying surgical procedures included perilymphatic fistula repair (n = 7) and microvascular decompression of the vestibular nerve (n = 1). Labyrinth destructive procedures included transmastoid labyrinthectomy (n = 2) and labyrinthectomy with vestibular nerve section (n = 1). One patient with vestibular schwannoma underwent both a disease-modifying and destructive procedure (translabyrinthine excision). All patients achieved excellent vertigo control, classified as per the American Academy of Otolaryngology – Head and Neck Surgery 1995 criteria.Conclusion:With the advent of intratympanic treatments, surgical treatments for vertigo have become further limited. However, surgery with directed intent, in select patients, can give excellent results.

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