Background: 

Congenital dislocation of the knee is a rare condition with an incidence of 1:100000 and can be idiopathic or syndromic. Our study evaluated percutaneous needle tenotomy for treatment of idiopathic flexible congenital dislocation of the knee.

Methods: 

A prospective case series was done on 15 infants with idiopathic congenital dislocation of the knee: nine boys and six girls. Closed reduction was first attempted, and if it failed the knee was examined. If the knee could be flexed beyond 0, serial casting was done. If the knee could not be flexed beyond 0, percutaneous needle tenotomy was done.

Results: 

Fifteen infants presented with idiopathic flexible congenital dislocation of the knee. Three dislocations were reduced closed, five were reduced with serial casting with gradual flexion, and seven that could not be flexed beyond 0 underwent percutaneous needle tenotomy. All patients could walk within the normal age range with no pain. All had full range of motion and good quadriceps function. Ultrasound was done in patients who had percutaneous needle tenotomy at walking age to ensure healing of the quadriceps tendon, which was adequately healed in all patients.

Conclusions: 

Percutaneous needle tenotomy is a good option for treatment of congenital dislocation of the knee. Careful selection of patients is mandatory.

Abstract

Background: This study evaluates submuscular locked plate in the pediatric femoral shaft fractures at the age from 6 to 12 years old.

Methods: A prospective study was done on 30 patients with fracture shaft femur. 18 of them were males and 12 of them were females. Fixation of all cases was done with a submuscular locked plate using the cluster technique.

Results: All fractures healed within 6 weeks. There have been no cases of non-union, malunion or infection.

Conclusion: Submuscular locked plate with cluster screw placement is a reliable and a useful option for fixation of pediatric fracture shaft femur.

Key words: Sub-muscular locked plate, pediatric fracture femur

Background 

Although the Ponseti method has been effective in early presented clubfoot, limited information is available on the use of this method in older patients.

Methods 

We prospectively followed 20 children (30 feet) with neglected idiopathic clubfoot. We sought to determine whether initial correction of the deformity (a plantigrade foot) could be achieved using the Ponseti method in untreated idiopathic clubfeet in patients presenting between the ages of 12–36 months.

Results 

Older children needed more casts than younger children. Twenty-one of 30 (70%) feet needed percutaneous tendo-Achilles tenotomy for residual equinus deformity. The mean dorsiflexion after removal of the last cast was 12.5°. Six feet relapsed (20%) and were treated with recasting and tibialis anterior transfer in four feet, and two feet needed limited medial release, tendo-Achilles tenotomy, abductor hallucis tenotomy, and tibialis anterior transfer.

Conclusions 

The Ponseti technique was effective in treatment of neglected clubfoot in patients between the ages of 12–36 months.

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