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SA Orthopaedic Journal

versão impressa ISSN 1681-150X

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LOUW, P  e  JANSEN VAN RENSBURG, NJ. Irreducible or missed lateral patellar dislocation. SA orthop. j. [online]. 2012, vol.11, n.2, pp. 72-75. ISSN 1681-150X.

The most common direction of patellar dislocation is lateral. The dislocation is usually recognised early and easily reduced. This case report highlights a young girl in which the dislocation was not recognised and subsequently became irreducible requiring an open reduction. CASE PRESENTATION: A 17-year-old girl sustained a lateral patellar dislocation during a twisting motion of the right knee while doing karate. On clinical examination the patient had a lateral patellar dislocation but the initial radiographs appeared fairly normal. Pre-operative CT examination confirmed the diagnosis. Closed reduction failed necessitating an open reduction. The lateral retinacular defect after reduction of the patella was filled using the anterior half of the iliotibial band. Eighteen months following surgery the patella was stable and the patient regained a good range of motion. CONCLUSION: Lateral patellar dislocation may be subtle and misdiagnosed. Not obtaining the necessary radiographs may contribute to not diagnosing the condition. Doubtful cases should have a CT scan to confirm the diagnosis. Mobilising part of the ITB is a viable option to obtain healthy living tissue to cover a lateral retinacular defect.

Palavras-chave : Irreducible; patella; dislocation; knee; ITB graft.

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