Benign acquired subluxation of the knee.

PURPOSE: To describe several cases of recurrent femorotibial subluxation episodes in pediatric patients, to review the existing literature about this rare entity, and to characterize its different clinical presentations. MATERIALS AND METHODS: The study included a series of three cases seen at our center. All patients underwent a structured anamnesis and complete physical examination, as well as a basic radiological study. One underwent magnetic resonance imaging. A literature search was performed in the main databases under the terms "Snapping knee" and "Femorotibial subluxation in child" to consult previous studies. RESULTS: Clinical onset was between 6 and 14 months of age, with episodes of femorotibial subluxations associated with irritability or fever. Examination showed increased joint laxity and a discrete genu valgum. Imaging studies showed no anatomical alterations. The symptoms gradually decreased in intensity and frequency. Two of the patients were treated with extension splints with no differences between them or with respect to the patient in whom therapeutic abstention was chosen. CONCLUSIONS: There are two independent presentations of the pathology that have not been well differentiated so far. The first (patients described from our clinical practice) is in initially healthy children who begin with episodes of subluxation in relation to febrile episodes or irritability, with an anodyne physical examination, and benign evolution with progressive reduction of the episodes even without treatment. The second presents as episodes of anterior subluxation since birth in patients with associated pathologies (usually spinal), anterior cruciate ligament instability, and need for surgical treatment to reduce the number of episodes.

Presentación de un caso de luxación abierta periastragalina y revisión bibliográfica / Epidemiology and Treatment of fracture-dislocations of the midfoot

La luxación periastragalina lateral abierta es una entidad infrecuente dentro de las lesiones que afectan al pie y tobillo. Se presenta el caso de una luxación periastragalina lateral abierta que se trató mediante reducción abierta por interposición del tendón del tibial posterior y posterior inmovilización con una férula suropédica. A los 7 meses el rango de movilidad era completo, sin inestabilidades y no doloroso. Este artículo remarca la importancia de cómo actuar de forma emergente con esta patología y realizar una reducción precoz para evitar problemas mayores. El uso de antibiótico precoz y de un lavado abundante de la luxación son los primeros pasos a seguir

Open lateral periastral dislocation is an infrequent entity within injuries that affect the foot and ankle. The case of an open lateral peritalar dislocation that was treated by open reduction by interposition of the posterior tibial tendon and posterior immobilization with a surpedic splint is presented. At 7 months the range of motion was complete, without instability and painless. This article highlights the importance of how to act emergently with this pathology and carry out an early reduction to avoid major problems. The use of early antibiotics and abundant lavage of the dislocation are the first steps to follow