The Official journal of the China Association of Rehabilitation of Disabled Persons and the 88th Hospital of PLA

Composite Impact Factor:

0. 948 (2015)

Total citation frequency: 3868 (2015)


ISSN 1005-8478

CN 37-1247/R

Manipulation therapy combined with polymer resin splint fixation for treatment of congenital dislocation of the knee in the infants

Author : CUI Ying-tie, FENG Yan-hua, XIE Dong-xiao, et al.     
Working unit : Childrens Hospital of Hebei Province, Shijiazhuang 050000, China
Page : 1968-1972
Key words : infant,congenital dislocation of the knee, manipulation therapy, splint

Abstract:

Objective

To investigate clinical outcome of manipulation therapy combined with polymer resin splint fixation for the treatment of congenital dislocation of the knee in the infants.

Methods

From December 2009 to November 2016, 26 infants32 kneeswith congenital dislocation of the knee, including 22 females and 4 males aged from 1 hour to 27 days after birth, were treated by the aforesaid methods in our hospital. Of them, 9 infants9 kneeswere diagnosed as simple knee dislocation, the other 14 infants18 kneeshad combined deformities, while the remaining 3 infants5 kneessuffered from syndromes. After daytime manipulation therapy for gradually increasing flexion of the knee, a reusable polymer resin splint was used for fixation at night until the knee reduction. Afterwards, the knee was maintained using a cast or brace to recover to stability. After treatment, regular follow-up was carried out.

Results

All patients were followed up for 6 months to 7 years. At the latest follow up, 27 knees of simple knee dislocation and combined deformities infants got complete correction of hyper⁃extention deformity with recovery of total range motion of flexion100%, while 3 knees of combined with congenital arthrogryposis multiplex had improvement in the flexion function of knee joint, 1 knees of combined with congenital arthrogryposis  multiplex had fundamental improvement in the flexion function of knee joint with a range of motion of joints 120 to meet the needs of daily life. However, 1 knee combined with Crouzon syndrome needed further surgical intervention due to improper function for normal life although obvious improvement in appearance also achieved. There was no significant difference in the range of motion between the three groups before treatmentP>0.05, but the degree of joint motion was significantly different after treatment between the patients with syndrome and those with simple dislocation and combined deformity P<0.05. At the last follow-up, the overall satisfaction rate was 96.88% and, there was no significant difference in the effect of knee joint treatment whether complete dislocation or subluxationP>0.05. Of the 32 knees including 10 knees of complete dislocation and 22 knees of subluxation, all the 22 knees with subluxation were graded as excellent, while 8 knees with complete dislocation graded excellent and 1 knee as good, by comparison, the remaining 1 knee combined with Crouzon syndromes graded as poor.

Conclusion

The infant, who suffers from congenital knee dislocation or subluxation whether or not combined with multiple deformities, can be effectively treated by daytime manipulation therapyandnight splint, without significant trauma caused by operation.


summary:
Manipulation therapy combined with polymer resin splint fixation for treatment of congenital dislocation of the knee in the infants   
CUI Ying-tie, FENG Yan-hua, XIE Dong-xiao, et al.
Orthop J Chin,2017,25(21):   1968-1972