Congenital Knee Dislocation at Birth - An Extraordinary Case of Spontaneous Reduction / Luxação congênita do joelho no nascimento - Um caso extraordinário de redução espontânea

Abstract Congenital knee dislocation (CKD) is a rare malformation characterized by hyperextension deformity of the knee with anterior tibia displacement, present at birth. Rarely reported, CKD might occur as an isolated deformity or commonly associated with musculoskeletal abnormalities, with the most common ones being developmental dysplasia of the hip (DDH) and clubfoot. The etiology is unknown, but CKD has been associated with certain intrinsic and extrinsic factors. Treatment with conservative methods at an early stage is most likely to yield successful results. We report here a rare case of successful spontaneous reduction of CKD in an infant within 24 hours of life.

Resumo A luxação congênita do joelho (LCJ) é uma malformação rara caracterizada por deformidade de hiperextensão do joelho com deslocamento anterior da tíbia, presente ao nascimento. Raramente relatada, a LCJ pode ocorrer como uma deformidade isolada ou comumente associada a anormalidades musculoesqueléticas, sendo as mais comuns a displasia do desenvolvimento do quadril (DDQ) e o pé torto congênito (PTC). A etiologia é desconhecida, mas a LCJ foi associada a certos fatores intrínsecos e extrínsecos. O tratamento com métodos conservadores em um estágio inicial tem maior probabilidade de produzir resultados bem-sucedidos. Relatamos aqui um caso raro de redução espontânea bem-sucedida de LCJ em um bebê nas suas primeiras 24 horas de vida.

Luxación congénita de cabeza radial: reporte de dos casos / Congenital radial Head dislocation: report of two cases

Resumen: Introducción: La luxación congénita de cabeza radial es un padecimiento que se ha descrito en contados casos en la literatura internacional, siendo la luxación anterior y lateral las formas de presentación menos frecuentes con 15% de los casos cada una y la luxación posterior la más frecuente con 70% del total de los casos reportados. Sin embargo, esta patología es considerada la patología congénita más frecuente del codo en el niño. Se presenta el caso de un paciente con luxación congénita de codo variedad anterior y otro caso con luxación variedad lateral, ambos diagnosticados a temprana edad, en los que se decidió realizar un manejo conservador y un seguimiento anual. Asimismo, se hizo una revisión bibliográfica del tema. Discusión: La luxación congénita de codo tiene por lo general una evolución benigna, siendo indolora y poco limitante para el paciente, por lo que puede ser manejada de manera conservadora. El dolor y la limitación de movimientos son indicativos de un tratamiento quirúrgico; sin embargo, no son ampliamente aceptados debido a las complicaciones y resultados deficientes que presentan.

Abstract: Introduction: Congenital dislocation of the Radial head is a condition that has been described in a few cases in the international literature, the anterior and lateral dislocation were the less frequent forms of presentation with 15% of cases, each, and the posterior dislocation the most frequent with 70% of the total cases reported. However, this pathology is considered the most frequent congenital pathology of the elbow in children. The present study describes the case of a patient with congenital dislocation of elbow anterior variety and another case with dislocation lateral variety, both diagnosed at an early age, in which it has been decided for conservative management and an annual follow-up. A bibliographic review of the subject is also carried out. Discussion: The congenital elbow dislocation usually has a benign evolution, being painless and not very limiting for the patient, so it can be managed conservatively. Pain and limited movement are indicative of surgical treatment. There are multiple surgical treatments for this entity, however they are not widely accepted due to the complications and poor results presented by them.

[Congenital dislocation of radial head [a case report]]

Congenital dislocation of radial head without any abnormality is rare, and commonly reveals with anomalies in another organs. It can be appearance in one side or two because of late manifestations, diagnosis of congenital dislocation of radial head is usually difficult. It is more important to recognize congenital anomaly of radial head from dislocation of elbow that events in trauma. This article presents one case of congenital dislocation of radial head that is involved one side without any anomaly

Larsen syndrome--lethal variety.

Larsen syndrome is a condition characterized by generalized defect in collagen formation. Autosomal dominant, autosomal recessive and even sporadic fresh mutations have been reported. Very few cases of lethal variety of Larsen syndrome have been reported in the world. The authors emphasize the importance of recognition of this condition which is often misdiagnosed.

Management of congenital atlanto-axial dislocation: some lessons learnt.

Congenital atlantoaxial dislocation (AAD) has a high incidence in India. In these patients, even a minor trauma may precipitate severe morbidity. The management of mobile AAD consists of posterior stabilization. In fixed AAD, the offending compressive element is present anterior to the cervicomedullary junction, which should be generously removed by the transoral approach. In many of these patients, the assimilated posterior arch of atlas or the incurving posterior margin of the foramen magnum or associated Chiari I malformation also adds to the compromise of the canal diameter at the foramen magnum. Thus, in cases of fixed AAD, the hour glass appearance of the spinal canal at the craniovertebral junction should be converted into a funnel shaped appearance which is close to normal. Since these procedures require a generous removal of the osteoligamentous structures, posterior fusion should be done in all cases after decompressive surgery. In this review, the observations that emerged during the management of congenital AAD are presented with a special focus on the assessment scales modified to the Indian settings, hypermobile AAD, rotary C1-2 dislocation, and AAD associated with Chiari I malformation and syringomyelia.

Congenital dislocation of knee: MRI diagnosis in a baby two days old

The case of a two days old female baby with congenital dislocation of left knee is presented, which was detected on observing abnormal passive movements. Clinical examination, plain X-rays, ultrasound and MRI examination was carried out. Closed reduction with anterior cast immobilization was performed and the patient followed up with X-rays upto two months

Luxaçäo congênita do joelho: revisäo crítica do tratamento cirúrgico: relato de um caso bilateral / Congenital luxation of the knee: critical review and surgical treatment: report of a bilateral case

Os autores apresentam o estudo crítico de um caso de luxaçao congênita bilateral do joelho. Realizam revisao pormenorizada da bibliografia procurando realçar os aspectos clínicos, radiográficos e o caráter envolutivo da deformidade. O tratamento cirúrgico é discutido nos seus detalhes de técnica, indicaçao e evoluçao. A classificaçao de Finder é adotada no trabalho por ser abrangente na graduaçao das deformidades de hiperextensao do joelho e na indicaçao correta do tratamento. O método cirúrgico empregado no trabalho deverá ser utilizado sempre que os meios conservadores convencionais falharem e nos casos irredutíveis de longa evoluçao sem tratamento prévio.

Congenital dislocation of the knee

Two sisters [siblings] were treated in Al-Razi Orthopaedic Hospital between July 1986 and November 1989 for bilateral congenital dislocation of their knees. The occurrence of the deformity in two sisters supports the familial aetiology of the condition. No other associated deformities or neurological deficits were found. We advocate early surgical treatment when manipulation fails to reduce the deformity

Genu recurvatum congénito: presentación de 4 casos / Congenital genu recurvatum: presentation of four cases

Se estudian 4 pacientes que presentaron genu recurvatum congénito; se indica la etiología, cuadro clínico, tratamiento y la evolución de estos casos. Se indica además, que dado lo poco frecuente de esta entidad, se realizó una revisión bibliográfica. Se dan conclusiones

Congenital dislocation of the knee: a review of four cases

Congenital dislocation of the knee [CDK] is a very rare condition, the incidence not being known with certainty. The etiology is also unknown. We reviewed four patients with severe CDK during the period of 1974-1986. The male/female ratio was 3:1. Three had bilateral and one unilateral dislocation. All were treated initially conservatively. Later three knees were operated upon. All treated knees have full range of movements except one which had secondary infection. The maximum follow up period [one case] is 12 years

Anatomia patológica do "genu recurvatum" congênito / The pathological anatomy of congenital \"genu recurvatum\"

A dissecçäo anatômica em uma criança com luxaçäo congênita do joelho é analisada. A hipotrofia universal da musculatura da coxa, o encurtamento e fibrose do músculo quadríceps sugerem uma doença neuromuscular de base. A luxaçäo anterior dos músculos isquiossurais, a contratura capsular anterior e a obliqüidade anterior dos ligamentos colaterais parecem ser alteraçöes secundárias