On the question of surgical treatment of habitual dislocations of the knee cap

R. Moulonguet (Bulletins et Mémoires de la Société de Chirurgie à Paris, Mars, 1928) recommends the following modified Krogius'a method: no circular skin incision, bypassing the kneecap from the inside and from below; the skin flap is folded up and out; a vertical incision, 2 cm outward from the outer edge of the knee cap, dissect the fibrous tissue and move the cup to its normal place. Then, from the inside of the knee cap, the aponeurosis of m is separated. vastus intern, in the form of an oblong flap 8-10 cm long and 2 cm wide, carefully separate it from the adjacent tissues, sparing the integrity of the muscle fibers and the joint capsule. This flap is carried outward from the knee cap, passing over its upper edge, and sutured into the wound made by the first vertical incision; the wound at the site of excision of the aponeurosis flap is pulled together with sutures. Immobilization within 10 days; on the 15th day it is allowed to get up. This transplant gives the kneecap a solid support. At the moment of stress m. quadriceps cruralis, when the patella tends to move outward, the muscle "tie" from the bundles of m. vastus intern, holds it in place.