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IMMEDIATE TREATMENT OF CONGENITAL KNEE DISLOCATION IN NEONATES N.Rumyantsev, A.Baindurashvili. G.Omarov
Congenital knee dislocation is a very rare deformity The incidence of
CDK:O.O1T is per 1000 live births (Jacobsen and Vopalecky,1985)
Purpose of the study: to determine the optimal treatment program for correction of ODK and restoring normal knee motion MATERIAL AND METHOD:
8 neonates with ODK underwent early conservative correction a 14 years period from 1986 to 2OOO. The treatment was started between the ages of 3 to 7 years old.
The first step included application of von Rosen splint. Hyper extended knees were moved Into correct position twice a day for 5-10 degrees each time.
Knee flexion up to the right angle was achieved in all patients during
the period The second step consisted of piaster cast applications. The knees were flexed to the right angle. At this point we used only circular casts.
The reserve space was created at the side of correction by special pads.
The reserve space allowed for an additional knee flexion of about 10
degrees (active motion, passive motion and growth of the segment Into the
side of flexion). The duration of cast fixation was about 10 to 14 days.
Therefore we obtained the full range of joint motion with in 3 to 5 days.
During the third step knee-flexed splints were applied
RESULTS:
The mean follow-up was 8 years. We used five clinical and radiological
criteria to evaluate the results (range of knee movement, stability, power of extension, functional ability). All results were good to excellent and without surgery.
CONCLUSION:
The treatment of CDK should be started with in a week of the child's birth.
We believe that CDK Is primarily a reversible condition, but the possibility of correction diminishes drastically with delay of treatment.
Application of von Rosen splint followed by circular casts with reserve space, provides good final results in all patients procedures were necessary.