Schreiner S, Ganger R, Grill F
Abteilung für Kinder- und Jugendorthopädie, Orthopädisches Spital Speising GmbH, Speisinger Straße 109, A-1130 Wien, Österreich.
Orthopade. 2012 Jan;41(1):75-82; quiz 83. doi: 10.1007/s00132-011-1874-7.
Congenital dislocation of the knee (CDK) is a rare deformity presenting itself either as an isolated idiopathic entity or in the context of syndromes like arthrogryposis, myelodysplasia or Larsen syndrome. Patients can be diagnosed clinically after childbirth based on hyperextension of the knee. Confirmation of the diagnosis is done by X-ray or sonography. Many theories concerning the pathogenesis have been proposed since CDK was described; according to recent literature fibrosis and contracture of the m. quadriceps is the most likely reason. Therapy should start as soon as possible after birth, conservatively using redressing casts or operatively in syndromal conditions aiming for reduction. The prognosis concerning re-dislocation is benign; a good outcome was shown for idiopathic CDK.
先天性膝关节脱位(CDK)是一种罕见的畸形,可表现为孤立的特发性疾病,也可出现在关节挛缩症、脊髓发育不良或拉森综合征等综合征的背景下。产后可根据膝关节过度伸展进行临床诊断。通过X射线或超声检查来确诊。自CDK被描述以来,已经提出了许多关于其发病机制的理论;根据最近的文献,股四头肌的纤维化和挛缩是最可能的原因。治疗应在出生后尽快开始,可以采用手法复位石膏保守治疗,对于综合征性疾病则采用手术复位。关于再脱位的预后是良好的;特发性CDK显示出良好的治疗效果。