Introduction: When we have operate children’s knee in habitual luxation of the patella we noted, that iliotibial band have branch going to patella and to patella tendon.

It is important to the etiopathology of the patella luxation, but in valgus of the knee and in hyperpresion of the patella syndrome too.

Material and Method: In years 2000–2007 we have performed surgical iliotibial band release In 70 children, 28 boys and 42 girls.

In 19 children contracture of the iliotibial band were one-sided, in 51 children contracture were both-sided.

Patients were divided in to groups with various pre-operative symptoms:

valgus of the knee – 40 patients (74 legs),

In all cases we performed surgically release of the iliotibial band. The incision was 5–10 cm over the joint space on the lateral side of the femur. The fasciotomy of the fascia lata and iliotibial band we make in “Z” shape. During operation we flex and extend the knee to be sure all fibres are released.

Findings: We have check late result (3 – 36 month postoperatively) in 45 patients (77 legs).

We estimate:

27 patients from group of valgus deformity of the knee

The valgus angle preoperatively reaches 12 to 35 (on average 16 for right leg and 16,5 for left). Postoperatively angle improve in all patients. Knee angle change from 5 to 20 degree (on average 8,4 for Wright leg, 8,3 for left).

In group with patella subluxation we have check 23 legs. In 11 patents (18 legs) the angle improve. The 3 patients (5 leg) later has full reconstruction of patello-femoral joint with patella tendon transposition. In patient with post inflammatory deformation the angle improve from 15 to 7 degree, but after next 34 month reaches again 20 degree and patient had osteotomy of the femur.

Conclusions:

iliotibial band release show us good result in correction the axis of the knee, first even during operation

The outcome of surgical treatment for congenital clubfoot depends, among other things, on obtaining correct repositioning of the tarsus in relation to the talus, i.e., peritarsal correction. This correction includes successfully repositioning the navicular, which is dislocated medially in relation to the head of the talus.

Evaluation of talonavicular repositioning is possible in older children when it is possible to observe the navicular bone on a radiograph. In radiographs of younger children between the ages of three and five, the navicular bone cannot be seen. USG examination may be helpful in the evaluation of talonavicular positioning, enabling better planning of the surgical procedure and its range.

In the Paediatric Orthopaedic Department of Medical Academy in Lublin from 1995 to 1999, 225 children (256 feet) were surgically treated. The peritarsal correction method (Turco) was used to manage 221 feet, and 31 feet by the subtalar release method according to Crawford by the incision of Cincinnati. Fifty-two feet were re-operated because of recurrent deformation.

USG examinations revealed incorrect positioning of the navicular bone. There was medial displacement in 24 feet (recurrent deformations), and wedge-shaped navicular bone in 18 feet and connected with dorsal displacement (overcorrection).

Medial displacements were observed in residual adductus deformation, whereas dorsal displacements were observed in feet with cavus or calcaneal deformity, which is connected with excessive lengthening of the calcaneal tendon (overcorrection).

USG examination in recurrent clubfoot enables the evaluation of talonavicular repositioning (not possible on radiographs) in younger children two to five years old, and is helpful to better plan the range of the operation.