title: Permanent patellar dislocation and osteoarthritis of the knee after femoral fracture in childhood. A case report.
abstract: A 52 year-old woman suffered bilateral femoral shaft fractures when she was 5 years old and they were treated surgically. She had been able to walk without pain and giving way throughout her young and adult life, however, when she came to us with a 1-year history of the right knee pain, she could walk only 10 m continuously. The right knee revealed valgus deformity with complete lateral patellar dislocation. The femoro-tibial angle was 154 degrees and arthritic change was seen in the femorotibial joint. Surfaces of both the patella and the femur were degraded. Twenty-two degrees of rotational deformity was also found internally in the involved side. Varus osteotomy with external rotation of the distal fragment and lateral retinacular release combined with reefing of vastus medialis muscle were performed. Twenty-four months after surgery, knee score and functional score were, respectively, 85/100 and 71/100, using knee society clinical rating system and there was no pain associating patella incongruity.
authors.affiliation: Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, 602-8566 Kyoto, Japan. nobuw@koto.kpu-m.ac.jp
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Watanabe
authors.forename: Yasuomi
authors.initials: Y
authors.lastname: Kubo
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Yoshino
authors.forename: Syoyo
authors.initials: S
authors.lastname: Mizutani
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Kubo
mesh_terms: D016025:Bone Transplantation; D002675:Child, Preschool; D005260:Female; D005264:Femoral Fractures / Q000150:complications*; D017759:Fractures, Malunited / Q000150:complications*; D006801:Humans; D016268:Internal Fixators; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000209:etiology; D010027:Osteotomy / Q000379:methods; D031222:Patellar Dislocation / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D052097:Quadriceps Muscle / Q000601:surgery; D011859:Radiography; D012399:Rotation