Congenital dislocation of the knee at birth - Part 2: Impact of a new classification on treatment strategies, results and prognostic factors
| Autor: | Philippe Wicart, Raphaël Seringe, M. Ramanoudjame, Virginie Rampal, Christophe Glorion, M. Mehrafshan |
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| Rok vydání: | 2016 |
| Předmět: |
musculoskeletal diseases
Male medicine.medical_specialty Knee Dislocation Tendons 03 medical and health sciences 0302 clinical medicine Traction medicine Cast immobilization Humans Orthopedics and Sports Medicine 030212 general & internal medicine Physical Therapy Modalities Retrospective Studies 030222 orthopedics business.industry Infant Newborn Retrospective cohort study Mean age Semiology Prognosis Surgery Splints Casts Surgical Treatment strategy Female Range of motion business Follow-Up Studies |
| Zdroj: | Orthopaedicstraumatology, surgeryresearch : OTSR. 102(5) |
| ISSN: | 1877-0568 |
| Popis: | Introduction An original classification of congenital dislocation of the knee (CDK) was drawn up, based on neonatal semiology. The objective of the present study was to assess impact on treatment decision-making and prognosis. Material and methods Fifty-one CDKs in 40 patients were classified neonatally into 3 types: I, reducible (n = 28); II, recalcitrant (n = 16); and III, irreducible (n = 7). Number of anterior skin grooves, range of motion (RoM), flexion deficit and reduction stability were recorded. Depending on reducibility, treatment comprised: physiotherapy with splints, traction with cast immobilization, or surgery. At follow-up, knees were assessed in terms of RoM and stability. Results Mean age at first consultation was 5.6 days (range: 0–30). Mean age at follow-up was 9 years (range: 1–26). Physiotherapy with splinting achieved stable reduction in all type-I knees. Five type-II knees (31%) required traction, none of which needed surgery. Four type-III knees (57%) required surgery. Outcome was good or excellent in 82% of type-I knees, good in 68% of type II and poor in all type-III knees. Conclusion The study confirmed the relevance of the present neonatal classification to treatment, with increasing rates of surgical indication and decreasing rates of satisfactory outcome from types I to III. Therapeutic attitude can be graded according to severity of CDK. Level of evidence IV, single-center retrospective series. |
| Databáze: | OpenAIRE |
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