KNEE DEFORMITIES IN LARSENS-SYNDROME

Thirty-eight cases of Larsen's syndrome were analyzed with an average follow-up of 13 years. Knee deformities were classified according to L eveuf and Pais grades: 12 patients had a grade 1 tibiofemoral dislocat ion, five had a grade two, and 18 had a grade 3. Six patients had isol ated dislocations or subluxations of the patella. Fourteen patients wi th 22 unstable knees were surgically treated. This series supports the idea of early treatment of knee problems, with an open procedure for grade 3 (resection of medial and lateral retinacula and iliotibial fas cia, V-Y reconstruction of the extensor apparatus, suture of the media l plane, medial transfer of one-third of the patellar tendon, capsulor aphy, tibiofermoral pinning, and plaster cast). Performing surgery on grade 2 dislocations is worthwhile only when they are accompanied by p atelofemoral dislocations. If they are grade 1, progressive casting in flexion is justified. Patellofemoral dislocations should be operated on early. Dislocatable patellas should be treated only if they interfe re with function.