Pediatric Distal Stabilization Procedures



Pediatric Distal Stabilization Procedures


Colleen Wixted

Meghan Price

Daniel W. Green

Shital N. Parikh



INTRODUCTION



  • Patellar dislocation is a common acute knee injury affecting the pediatric and adolescent populations.1,2 Nonsurgical conservative treatment involving physical therapy and activity modification is usually recommended for first-time traumatic patellar dislocations. Many surgical techniques have been described to address patellar instability, but medial patellofemoral ligament (MPFL) reconstruction and/or distal realignment are among the most common procedures used.3,4 This chapter focuses on distal realignment techniques specifically for the skeletally immature.


  • Tibial tubercle osteotomies, the Roux-Goldthwait procedure, patellar tendon transfer, Nietosvaara technique, combined MPFL and medial patellotibial ligament (MPTL) reconstruction, and the Galeazzi technique are among the various procedures that have been developed to address distal malalignment issues.


  • Tibial tubercle osteotomies are only indicated in adolescents if the proximal tibial physis is closed or closing.5 These techniques are discussed in Section III.


  • Many variations of the other procedures exist, some of which are no longer regularly performed because of poor reported outcomes.6,7 Each of these techniques will be discussed—focusing primarily on those that have demonstrated higher success rates.




OVERVIEW OF SURGICAL TECHNIQUES



Patellar Tendon Transfer

Dec 1, 2019 | Posted by in ORTHOPEDIC | Comments Off on Pediatric Distal Stabilization Procedures
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