abstract modifed roux-goldthwait

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case report

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Modified Roux - Goldthwait procedure as an operative management for habitual dislocation of the patella1Muharriansyah. 2Safrizal Rahman

1PPDS Bedah FK.Unsyiah/RSUZA

2Divisi Bedah Orthopedi FK.Unsyiah/RSUZA Banda Aceh

Intruduction

Subluxation and dislocation of the patellofemoral joint is the common cause of knee pain and instability in childhood. The most common symptoms is giving way, popping sound and patellar dislocation which only can be reduced manually. The etiology of the patellar instability are genu valgum, genu recurvatum, patella alta, patella dysplasia, trauma, femoral anteversion, external tibia torsion, ligamentous laxity, congenital abnormally and nail patella syndrome.

CASE REPORTS

A case, female 16 years old, suffering from habitual dislocation of the patella treated with Roux-Goldthwait procedure, a modification had been done by releasing lateral retinakulum of the patella and placation of the medial retinaculum. This modification was done to prevent recurrent case. Lateral retinaculum of the patella was release with incision at the level of tibia tuberosity and advanced proximally with intraarticular exposure. Post operative evaluation showed no lateral dislocation of the patella on passive flexion of the knee joint.

DISCUSSION

There are many conservative and operative procedure that can be done to treat patellar dislocation cases in childhood. But for habitual cases, the operative procedure is the best choice. Roux-Goldthwait procedure has been widely used and has been through many modifications. The main principal is to bring back the patella to its center position by cutting patellar tendon vertically right in the middle, the lateral half was release from its attachment in tibia tuberosity and then slipped under the medial half and then sutured to soft tissues on the medial side of the tibia, if possible to the insertion of the Sartorius muscle. This procedure will prevent the lateral dislocation of the patella.

Keyword : Patellofemorar dislocation habitual, Roux-Goldthwait procedure modofication

Dislocation of patella

x-ray dislocation of patella

screwing SIAS bone to epicondyler femur

dislocation of patella incision

xray post operation

Clinis post operation

CONCULSION

Modified Roux-goldthwait procedure surgery for recurrent patellar dislocation results in a successful improvement in RSUDZA Banda Aceh, a low redislocation rate, and an acceptable complication rate. Despite this, there is no consensus on indications for Modified Roux-goldthwait procedure reconstruction, graft type, surgical technique, and rehabilitation program. In this case the Modified Roux-goldthwait procedure is better, now patients have gone home and ambulatory care through poly