Paediatric First-Time Patella Dislocators: An Approach to Conservative Management
| Autor: | Mahadev Arjandas, Lam Kai Yet, Looi Collin |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty brace paediatric Conservative management medicine.medical_treatment Population Physical Therapy Sports Therapy and Rehabilitation 03 medical and health sciences 0302 clinical medicine Primary outcome lcsh:Orthopedic surgery medicine Orthopedics and Sports Medicine patella instability education First episode 030222 orthopedics education.field_of_study Rehabilitation business.industry Incidence (epidemiology) 030208 emergency & critical care medicine patella dislocations musculoskeletal system Brace Surgery lcsh:RD701-811 conservative Physical therapy Patella business |
| Zdroj: | Journal of Orthopaedics, Trauma and Rehabilitation, Vol 23, Iss C, Pp 30-33 (2017) |
| ISSN: | 2210-4925 2210-4917 |
| Popis: | Background First-time lateral patella dislocations are generally treated nonoperatively. However, the ideal form of conservative management and immobilization remains unknown. We compare the clinical outcomes after different immobilization methods. Methods Paediatric-age patients that met our inclusion criteria, and presenting with a first episode of lateral patella dislocation to our hospital from 2006 to 2013, were enrolled. Different immobilization methods included brace, backslab, or cylinder cast. A retrospective review was performed to compare bracing against other immobilization methods, using a primary outcome measure of redislocation rate, and secondary outcome measures like progression to surgery, range-of-motion, pain, and weight-bearing status. Results A total of 142 patients (with 147 affected knees) with minimum 1 -year follow-up were included in the study. Bracing was found to be superior to other immobilization methods in preventing repeat dislocations, and need for subsequent surgery. At 6 weeks, patients treated with the backslab had the highest incidence of pain. There were no differences with regards to range-of-motion or weight-bearing status. Conclusion We recommend the use of a brace, with a progressive rehabilitation protocol in the management of first-time lateral patella dislocators. This study is also unique, in that it specifically addresses nonoperative management of first time patella dislocators in a paediatric-age population group. |
| Databáze: | OpenAIRE |
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