Treatment of Dislocation of the Patella.

概要

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Numerous surgical methods have been described for correction of dislocation of the patella.We have treated ten patients with patellar dislocation and evaluated various operative methods used.Dislocation of the patella is classified as congenital, permanent or recurrent type. In all either the etiology is thought to be due to a lateral shift of the quadriceps muscle.It is possible to treat the congenital type with both closed manipulation and casting.In the recurrent type, the quadriceps muscle slightly shifts to the lateral side therefore making transposition of the tibial tubercle taking the patellar ligament medially necessary for recovery.The permanent type is residual to the congenital type, associated with a severe lateral shift of the quadriceps muscle. It is necessary to treat this type with not only transposition of the tibial tubercle moving the patellar ligament medially but also reefing of the fascia of the Vastus Medialis and Rectus Femoris muscles.Treatment of patellar dislocation aims at correcting the lateral shift of the quadriceps muscle.We suggest that surgical procedures which sacrifice muscles are not recommended.
西日本整形・災害外科学会の論文