Aplasia of the patellar tendon rarely has been reported in the orthopaedic literature. In a MEDLINE search from 1963 through 2004, we found only four reported cases1-3: two had been detected with use of magnetic resonance imaging in patients with fibular or tibial hemimelia (noted in one patient each)3, one had been discovered with use of ultrasound in a nine-day-old girl with tibial hemimelia1, and one had been noted in a twenty-five-year-old woman with bilateral congenital absence of the patellar tendon2. None of these three reports described the indications for surgery or the results of attempted reconstruction.
We present the cases of two patients who had congenital aplasia of the patellar tendon associated with shortening of the involved limb. One patient underwent reconstruction of the patellar tendon; the other was treated nonoperatively. The parents of both patients were notified that data concerning the cases would be submitted for publication.
Case 1. An eight-year-old boy presented to our institution with lower-extremity limb-length inequality (with the left lower limb being shorter than the right).' This condition caused the boy to limp and interfered with activities of daily living and sports activities.
During pregnancy, the patient's mother had had eclampsia with severe hypertension. Ten weeks prior to the due date, it became necessary to deliver the child by cesarean section. The boy weighed 1250 g at birth and was monitored for ten weeks in the intensive care and intermediate care units. The family history was negative for musculoskeletal abnormalities, and an older brother was normal. When the child was two months of age, a skin depression developed over the lateral aspect of the left femoral condyle and an extension lag of the knee was observed. When the patient reached six months …
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