Li Tengyao, Weng Jiewei, Li Tianyou
Department of Pediatric Orthopedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
Transl Pediatr. 2025 Apr 30;14(4):748-753. doi: 10.21037/tp-2024-594. Epub 2025 Apr 27.
Congenital patellar dislocation (CPD) is a complex disease lacking consensus on the treatment. While genu valgum is a risk factor for patellar dislocation in general, it is less common in the congenital cases. In this report, a retrospective analysis of a child with bilateral CPD and genu valgum is presented, detailing the clinical characteristics, diagnostic approach, surgical intervention, and outcomes.
A 3-year-old boy presented with an abnormal gait and Klinefelter syndrome. Comprehensive preoperative imaging evaluations were made to assess osseous and soft tissue morphology, revealing bilateral CPD and genu valgum which localized to proximal tibia and knee joint. Surgical correction involved open reduction of both patellar dislocations with lateral retinacular release, medial retinacular reefing, temporary proximal tibial epiphysiodesis by eight-plate, and iliotibial band lengthening. Intraoperative patellar stability was satisfactory. At the 3-year follow-up, the patient showed normal patella tracking and favorable knee function.
CPD is a rare and complex pediatric disorder lacking a universally accepted treatment strategy. To date, there have been no reported cases of CPD presenting both genu valgum and Klinefelter syndrome. The immature skeletal system in children necessitates careful consideration of surgical techniques and early diagnosis to optimize growth, correct deformity, and ensure mobility. For the case, as the patellar dislocation and genu valgum can influence each other, a single-stage operation addressing both simultaneously was performed, resulting in a favorable outcome.
先天性髌骨脱位（CPD）是一种复杂疾病，在治疗上缺乏共识。虽然膝外翻一般是髌骨脱位的危险因素，但在先天性病例中较少见。本报告对一名双侧CPD并膝外翻患儿进行回顾性分析，详细介绍其临床特征、诊断方法、手术干预及结果。
一名3岁男孩因步态异常及克兰费尔特综合征就诊。术前进行了全面的影像学评估以评估骨与软组织形态，发现双侧CPD及膝外翻，病变位于胫骨近端和膝关节。手术矫正包括双侧髌骨脱位切开复位、外侧支持带松解、内侧支持带折叠、用八孔钢板临时行胫骨近端骨骺阻滞及髂胫束延长术。术中髌骨稳定性良好。在3年随访时，患者髌骨轨迹正常，膝关节功能良好。
CPD是一种罕见且复杂的儿科疾病，缺乏普遍接受的治疗策略。迄今为止，尚无CPD合并膝外翻和克兰费尔特综合征的报道病例。儿童未成熟的骨骼系统需要仔细考虑手术技术并进行早期诊断，以优化生长、纠正畸形并确保活动能力。对于该病例，由于髌骨脱位和膝外翻可相互影响，因此同时对两者进行了一期手术，取得了良好效果。
