ObjectiveTo evaluate the clinical and functional results of a surgical treatment of patellar dislocation whose etiology was iatrogenic quadriceps fibrosis in children.Materials and methodsA prospective study was undertaken from February 2004 to December 2009. The study included 54 pediatric patients (56 knees) that had developed dislocation of the patella after repeated intramuscular injections of antibiotic(s) into the quadriceps muscle. There were 11 males (20.4 %) and 43 females (79.6 %). The patients’ mean age at surgery was 7 years, 9 months (range 6 years, 4 months to 12 years, 6 months). A complete history of each patient was recorded. The affected knees were evaluated preoperatively and postoperatively on the basis of the symptoms, signs, and roentgenographic findings. Patellar dislocation was classified according Bensahel’s criteria. All patients had a three-part surgical procedure that combined capsulorrhaphy, quadricepsplasty, and transfer of the vastus medialis oblique to the superior border of the patella.ResultsThere has been no poor postsurgical result or recurrence so far; we have noted an ugly scar in nine knees (16.1 %), limitation of the knee flexion in five knees (8.9 %), and loss of extension of 5 °–20 ° in four knees (7.1 %). Overall, we attained excellent results in 39 knees (69.7 %), good results in 13 knees (23.2 %), and fair results in four knees (7.1 %).ConclusionIn our cases of pediatric dislocation of the patella caused by iatrogenic quadriceps fibrosis, the introduced three-part surgical procedure has shown great success in restoring the realignment mechanism of the patella. The technique is simple, safe, and effective in skeletally immature children.

Background: The Innominate osteotomy as an integral component of combined open reduction for the treatment of dysplasia developed of the hip in children. Materials and Methods: Between 2011 and 2015, 198 hips of 176 patients with developmental dislocation of the hip underwent 0 operation. The patients were divided into two Variant based on the age at the time of open reduction: 12 months -less than 18 months (Variant 1) and upper 18 -36 months (Variant 2). There were 120 hips in V 1 and 69 hips in V 2. Preoperative Patients didn't use skin or skeletal traction, or femoral osteotomies. All patients were Open reduction and iliac osteotomy according to Zigzag morphology combined Fibular Allograft. Dislocations were graded according to Tönnis system. The acetabular index was measured common procedure: Clinical evaluation of modified McKay criteria, and Roentgenographic evaluation of Severin. Results: There were 134 (76.1%) of the patients were girls and 42 (23.9%) were boys. Twenty two (12.5%) patients were affected bilaterally. The right hip was involved in 31 (17.6%), and the left hip in 123 cases (69.9%). Tönnis grade: Tönnis 3 in 46 (23.3%), Tönnis. 4 in 152 (76.7%). The patient was performed at a mean age of 21.5 months (12 to 36) and the mean age at latest follow-up was 72.1 months (58 to 115), and the mean time follow-up was 41 months (32 to 53 months).Overall favorable result 188 hips (94.9%) and unfavorable result 10 hips (5.1%). Roentgenogrphic results were Excellent 79.8%, Good 15.2%, Fair 3.5%, Poor 1.5%. There were Redislocation 14 (7.1%) and Avascular necrosis 47 (23.7%). Conclusion: This operation was of good safety and efficacy. Fibular allograft was strength and graft was not resorption, more stable and structurally sound interposition material which could be contoured to the shape of the osteotomy site. The Zizag octeotomy acetabuloplasty the same shape of the acetabulum by hinging the horizontal branch of the triradiate cartilage following an incomplete osteotomy. At latest results, both Variant were none different.

Objective: To evaluate the clinical and functional results of two surgical treatments of patellar dislocation in children. Material and Methods: A prospective study was undertaken from January 1995 to December 2009. Pre-postoperatively, the clinical and roentgenographic examinations were performed. Patellar dislocation was classified according to Bensahel's criteria. There were two surgical techniques performed: 1) the iliotibial tract passing through patella (ITT), and 2) transferring vastus medialis oblique muscle to superior border patella (VMO). Lateral retinacula were released to restore the tension of the medial retinacula and quadricepsplasty was used in all patients. The results of the operations were classified according to Kujala's functional knee-scoring systems. Results: 128 patients (132 knees) were operated. There were 20 males and 108 females. 94 knees (71.2%) were Type 1, and 38 knees (28.8%) were Type 2. The ITT was in 74 patients (76 knees), and VM was in 54 patients (56 knees). Clinical signs, imaging finding before and after the operation and operative results of these patients were operated with ITT and VM with no significant difference (p > 0.05). Overall, we attained excellent results in 95 knees (72.0%), good results in 30 knees (22.7%), and fair results in 7 knees (5.3%). There have been no poor results or recurrences so far. Conclusion: These techniques are simple, safe and effective in skeletally immature children. Long-term follow-up of these patients was operated ITT and these patients which were operated VMO were not different, but time for operation was: ITT: 65 minutes, and VMO: 55 minutes.

BACKGROUND: This study aimed to evaluate the results of the previous method of anterior open reduction done in children <12 months of age. METHOD: Patients who underwent an anterior open reduction in the typical hip dysplasia between 2012-2018 were screened retrospectively. The study included 12 hips of 12 patients. The corrected percentage of acetabular index is calculated by measurements of acetabular angles performed prior operation and at the final examination. Avascular necrosis (AVN) is classified according to the criteria of Kalamchi-MacEwen while X-ray and clinical evaluation is performed by Severin and McKay criteria. RESULTS: The average age for surgery was 9.91 months (9-11 months) while the average follow-up time was found to be 52.75 months (43-64 months). According to the radiology criteria Severin, Eveluating patients after surgery with Excellence 5 (41.7), Good 4 (33.3%), Mediation 2 (16.7%), Poor 1 (8.3%). Whereas, according to the rating based on McKay criteria, Excellent 8 (66.7%), Good 3 (25.0%) and Poor 1 (8.3%). Avascular necrosis (AVN) of the femoral head has been encountered in 1 (8.3%) of 12 hips. According to the criteria of Kalamchi-MacEwen Classification; 1 unveiled type I avascular necrosis, respectively. CONCLUDE: We have encountered according to outcomes data of this study that open reduction technique by the anterior approach for treatment of developmental dysplasia of the hip (DDH) presented more successful clinical and radiological outcomes in the 9-< 12 months old infants.