الفهرس 
Acknowledgment
ClassificationOnly 14 pages are availabe for public view
 |  | from | 79 |  |  |
| | | from | 79 | | |
Abstract
- Congenital dislocation of the knee is a spectrum of disease including positional contractures and rigid dislocation .
- Structural components include quadriceps tendon contracture , anterior subluxation of hamstring tendon ,absent suprapatellar pouch ,tight collateral ligament.
- Often occurs in children with myelomeningocele and arthrogryposis and larsen’s syndrome , often associated with developmental dysplasia of the hip, clubfoot, and metatarsus adductus .50% of patients with congenital knee dislocations will have hip dysplasia affect one or both hips
- Presents with hyperextened knee at birth.
•Treatment :
-Non-operative treatment
Most cases can be treated nonoperatively if both knee and hip dislocated, then treat knee first cant get Pavlik harness on hip if knee dislocated technique by long leg casting on weekly basis
- Operative treatment
Surgical soft tissue release
Indications if failure to gain 30 degrees of flexion after 3 months of casting .Goal of surgery is to obtain 90 degrees of flexion with quadriceps tendon lengthening (V-Y quadricepsplasty or Z lengthening,PQT) ,anterior joint capsule release hamstring tendon posterior transposition collateral ligaments mobilization .
- PERCUTANEOUS QUADRICEPS TENOTMY
This procedure is ideally performed at 1 to 2 months of age and is described by Roy and Crawford.
• An assistant holds the affected leg and attempts to flex the knee.
• A small stab incision is made one to two patellar lengthssuperior to the patella in the midline of the thigh, and the fascia overlying the rectus femoris is released.
• Medial and lateral stab incisions are then made at the superior border of the patella to release the medial and lateral quadriceps tendon and retinaculum.
• After the release is performed, the knee is flexed to 90degrees.Sterile dressings are applied, followed by a long-leg plaster cast with the knee flexed at 90 degrees or greater.The cast is worn for 4 to 6 weeks.