It is desired to emphasize again the statement that the acquired and congenital patellar luxations have not been carefully differentiated and that similar operative procedures are manifestly illogical of application to dissimilar surgical problems.
The acquired luxations invite the solution of a problem in faulty functional joint mechanics. In distinction, the congenital lesions demand the reduction of a fixed dislocation and an anatomic restoration before the functional mechanism can be considered.
The above procedure accomplished the correction of the genu valgum and the tibial rotation, without a violation of the bony continuity, by the preliminary application of successive corrective plaster casts.
The unavoidable defect resulting from the open reduction of the fixed patellar luxation was completely repaired by the free transplantation of redundant capsular and synovial tissue.
Finally, the permanency of the reduction was assured by the reefing of the mesial capsule and a reconstruction of the lines of torsion of the extensor mechanism with which the patella is integral.
(C) 1925 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.