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Congenital knee dislocation {CDK}
 | | fig.1a |
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Congenital knee dislocation is a very rare deformity, its incidence is
0,017 per 1000 live births {Jacobsen and Vopalecky , 1985} According to our
data, 30 to 40 children with CDK (Congenital knee dislocation) are born in Russia every year.
The beginning of treatment is usually conservative - manual
correction, splinting or Plaster-of-Paris immobilization. If unsuccessful,
by the age of 3 months surgery is needed. For the last 15 years we were
working on improvement of early conservative treatment technique.
Today our experience is considered to be one of the most successful in the world. Our
methods were presented during the First International Congress of Pediatric
Orthopedic Societies {Sendai, Japan, 2001}.
Since then 2 years passed, and
we have achieved a 5-day correction period of CDK (Congenital knee dislocation) and excluded circular
plaster immobilization. Therefore, the whole treatment procedure was taking
place in maternity hospital. Neither of our patients needed surgical
treatment.
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Our article concerning CDK (Congenital knee dislocation) will be published in JPO as soon as
possible.
Meanwhile we would like to present an interesting case of severe CDK.
Patient A. {fig.1, 1a} was born in one of the maternity hospitals in
St.Petersburg on January 30-th, at 3:00 p.m. with CDK (Congenital knee dislocation). Therefore, an
orthopedists was urgently called.
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 | | fig.2 |
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The specialist after evaluating the case
considered it to be severe: complete dislocation, range of motion from 90
degrees retroflexion to 10 degrees of correct flexion. Treatment was started
on the first day of life - a von Rosen splint was applied {fig.2}.
Hyperextended knees were moved into correct position twice a day for 5 to 10
degrees each time. Knee flexion up to the right angle was achieved during
the 4 days, and Plaster-of-Paris splints ware applied for a period of 5
days.
After that,the knee motion was 180/70 {fig.2, 3}, and baby was discharged from the maternity hospital.
No additional plaster fixation was needed .The baby was examined by 5
different orthopedic surgeons at the age of 3 months, and there was no
notification of any knee abnormalities.
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