Roux-Goldthwait technique

Dislocation of the humerus is divided into acute traumatic patellofemoral dislocation, recurrent patellofemoral dislocation and congenital dislocation of the tibia due to local causes of dislocation, degree of deformity and range. From the degree of displacement, it is divided into complete dislocation and incomplete dislocation (ie subluxation). Acute traumatic dislocation of the tibia, often in the joint capsule relaxation, weak femoral muscle weakness, femoral external dysplasia, shallow truncated concave part, flattened tibial articular surface, etc., suddenly suffered external forces, the humerus easily slipped out of the femoral block . In principle, the treatment is to use non-surgical treatment; sometimes a severe knee medial support band and joint capsule rupture require surgery. Recurrent patellofemoral dislocation can occur with a minor trauma or no history of trauma, and dislocation can occur repeatedly, often to the lateral dislocation of the knee. Dislocation often occurs on the basis of knee dysplasia; the soft tissue of the knee is weak, and the soft tissue of the lateral knee is contracted. Sometimes the individual muscle bundles of the lateral femoral muscle directly stop above the humerus; the humerus is small, the lateral part is flat, and the tibia is more High, the lower end of the femur, especially the lateral malleolus dysplasia, knee valgus, external rotation of the humerus, internal rotation of the lower end of the femur. When the knee joint is turned from the straight position to the flexion position, the tibia gradually slides to the outside of the knee. Once dislocated, the knee can not actively extend; if the tibia is controlled in the intercondylar fossa at the knee extension, the knee flexion is difficult or even impossible. Such dislocation non-surgical treatment is difficult to achieve and requires surgery. Congenital dislocation of the tibia is often bilateral, and non-surgical therapy cannot be automatically reset. Because there are many factors causing dislocation of the humerus, and they are different, the treatment should be based on the specific circumstances of the patient, using different surgical methods or several surgical methods to achieve the purpose of treatment. Pay attention to the following principles when choosing a procedure: 1. In order to relieve the traction of the tibia to the outside, all the soft tissues of the outside of the iliac crest, including the tendon bundle, the quadriceps expansion and the joint capsule, should be fully released. 2. Use the tendon shaping method to strengthen the contractile strength of the medial tibia muscle, and if necessary, transplant the semitendinosus to the tibia. 3. Adjust the pulling direction of the knee extension device. If the traction force is not resolved, the dislocation of the patella is still inevitable. 4. When the tibial resection is sutured, it is necessary to pay attention to whether the pulling direction of the knee extension device follows the femoral condyle. If the pulling direction is not correct, it must be adjusted. 5. The dislocation of the humerus caused by knee valgus deformity can be solved by osteotomy. The specific osteotomy site should be carefully designed after X-ray filming. 6. If the articular cartilage is extensively damaged, knee fusion or artificial knee replacement should be considered. 7. In children, if the femoral intercondylar fossa is found to be shallow, there is no need to deepen the operation. It is reported that as long as the humerus is reset, in the case of frequent movement of the knee joint, the intercondylar fossa can be gradually shaped and deepened in the future. Treatment of diseases: dislocation of the humerus Indication Roux-Goldthwait is suitable for: 1. Mild recurrent hernia dislocation. 2. Children whose tibial tuberosity has not been completed. Surgical procedure Incision A median straight incision is made from the lower edge of the humerus to the tibial tuberosity. 2. Free and transplanted lateral half Retract the skin incision to both sides, reveal the sputum, cut the sacral line, divide into the inner and outer halves, cut the outer half of the sacral point at the tibial tuberosity, and wrap it around the medial half The inner side is tightened to the inside, and is sutured with the sartorius muscle stop point and the soft tissue inside the knee. 3. Suture the incision according to the level.