Lin Kenneth M, Thacher Ryan R, Apostolakos John M, Heath Madison R, Mackie Alexandra T, Fabricant Peter D
Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A.
Pediatric Orthopedic Surgery Service, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A.
Arthrosc Tech. 2021 Feb 22;10(3):e913-e924. doi: 10.1016/j.eats.2020.11.012. eCollection 2021 Mar.
Pediatric patellofemoral instability is a complex problem, for which there are several anatomic risk factors. Coronal plane malalignment (i.e., genu valgum) is one cause of patellofemoral instability, and treatment of genu valgum has been associated with improved patellofemoral stability. Coronal plane angular deformity correction, typically achieved by distal femoral osteotomy in the adult population, can be achieved with less invasive surgical techniques in pediatric patients using implant-mediated guided growth. By temporarily tethering one side of an open physis to generate differential growth in the coronal plane, valgus malalignment can be corrected. We present our technique for medial distal femoral implant-mediated guided growth using tension band plating for treatment of pediatric patellofemoral instability associated with genu valgum. This technique is minimally invasive, has a low complication rate, and in conjunction with conventional treatment can reduce the risk of recurrent instability.
小儿髌股关节不稳定是一个复杂的问题，存在多种解剖学危险因素。冠状面排列不齐（即膝外翻）是髌股关节不稳定的一个原因，膝外翻的治疗与髌股关节稳定性的改善相关。冠状面角畸形矫正通常通过成人的股骨远端截骨术来实现，而在小儿患者中，使用植入物介导的引导性生长这种侵入性较小的手术技术也可以实现。通过暂时束缚开放骨骺的一侧以在冠状面产生差异性生长，可以矫正外翻畸形。我们介绍了使用张力带钢板进行股骨远端内侧植入物介导的引导性生长的技术，用于治疗与膝外翻相关的小儿髌股关节不稳定。该技术微创，并发症发生率低，并且与传统治疗相结合可降低复发性不稳定的风险。
