A treatise on orthopedic surgery . he patella may be displaced upward as a result of extremegenu recurvatum, and in rare instances it may be displaced in-ward or downward, but far more often the displacement is out-ward. Fifty cases of this form are recorded, in most of whichit was a complication of congenital genu valgum. Acquired complete displacement in which the patella lies onthe outer aspect of the external condyle is most often an accom- 458 OBTHOFEDIC SUEGEBY. paniment of extreme genu valgum. The first step in treatmentmust be to remedy the distortion of the limb, but if the de-formity
A treatise on orthopedic surgery . he patella may be displaced upward as a result of extremegenu recurvatum, and in rare instances it may be displaced in-ward or downward, but far more often the displacement is out-ward. Fifty cases of this form are recorded, in most of whichit was a complication of congenital genu valgum. Acquired complete displacement in which the patella lies onthe outer aspect of the external condyle is most often an accom- 458 OBTHOFEDIC SUEGEBY. paniment of extreme genu valgum. The first step in treatmentmust be to remedy the distortion of the limb, but if the de-formity is of long duration the tissues on the anterior aspectwill have become so shortened that flexion will be much limited. SLIPPING PATELLA. This term is applied to an abnormal laxity of the supportingtissues that allows occasional displacement of the patella uponor to the outer side of the external condyle. Etiology.^—This disability is more common among femalesthan males, and is more often unilateral than bilateral. The Fig. Slipping patella of the left side. abnormal mobility may be an inherited peculiarity; it may bedue to weakness of the quadriceps extensor muscle, or to imper-fect development of the patella or of the external condyle ; or theoriginal displacement may have been due to injury. In manyinstances, however, the predisposing cause is genu valgum, as aconsequence of which the patella is carried toward the externalcondyle. Slight occasional displacement sufficient to cause dis-comfort is a not uncommon accompaniment of weak feet, anindication as a rule of muscular weakness or relaxation. NON-TUBEECULOUS AFFECTIONS OF KNEE-JOINT. 459 Weimuty has collected 66 cases. Of these 32 were of con-genital, 14 of traumatic (rupture of internal ligaments), and 20of pathological origin (knock-knee). Symptoms.—If the slipping of the patella is a frequent occur-rence it causes comparatively little pain, but when the parts areless relaxed the dis^Dlacement is likely to be
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