Quadricepsplasty for congenital dislocation of the knee and congenital quadriceps contracture

Tercier, Stephane and Shah, Hitesh and Joseph, Benjamin (2012) Quadricepsplasty for congenital dislocation of the knee and congenital quadriceps contracture. Journal of Children's Orthopaedics, 6 (5). pp. 397-410.

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Abstract

Purpose We encountered problems with the Curtis and Fisher technique of quadricepsplasty for congenital quadriceps contracture, including wound dehiscence, insufficient lengthening of the quadriceps and instability of the knee. We modified the operative technique to address these hree problems. We undertook this study to evaluate the results of the modified technique of quadricepsplasty to determine if we succeeded in overcoming these limitations of the original technique. Methods Twenty children (33 knees) underwent the modified Curtis and Fisher quadricepsplasty through a lateral incision; a long tongue of the rectus femoris was raised and the vasti mobilised without dividing the lateral retinaculae till the collateral ligaments. The children were followed up for a mean period of 63 months and evaluated. The healing of the wound, active and passive range of motion (ROM) of the knee, the stability of the knee, quadriceps power and knee function were assessed. Results Primary wound healing occurred in 32 of 33 knees. Adequate lengthening of the quadriceps sufficient to facilitate knee flexion to 90� was possible. Considerable improvement in the ROM was noted. In non-syndromic congenital dislocation of the knee (CDK), the quadriceps power was Grade 5, but minor degrees of extensor lag was noted. In a proportion of patients, minor degrees of joint instability was present. The majority of children were community walkers. The overall results were better in nonsyndromic CDK than in children with arthrogryposis, but differences of some variables were not significant. Conclusion The modifications to the original Curtis and Fisher technique overcame the specific problems they were expected to avoid.

Item Type: Article
Uncontrolled Keywords: Congenital quadriceps contracture,Congenital dislocation of the knee, Quadricepsplasty, Knee instability
Subjects: Medicine > KMC Manipal > Orthopaedics
Depositing User: KMC Manipal
Date Deposited: 08 Apr 2013 07:19
Last Modified: 08 Apr 2013 07:19
URI: http://eprints.manipal.edu/id/eprint/79525

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