title: Quadricepsplasty for knee stiffness after femoral lengthening in congenital short femur.
abstract: We review the results of a modified quadricepsplasty in five children who developed stiffness of the knee after femoral lengthening for congenital short femur using an Ilizarov external fixator which spanned the knee. All had a full range of movement of the knee before lengthening was undertaken. Unifocal lengthening was carried out in the distal metaphysiodiaphyseal region of the distal femur with a mean gain of 6.5 cm. The mean percentage lengthening was 24%. At the end of one year after removal of the Ilizarov frame and despite intensive physiotherapy all patients had stiffness. Physiotherapy was continued after the quadricepsplasty and, at the latest follow-up (mean 27 months), the mean active flexion was 102 degrees (80 to 130). The gain in movement ranged from 50 degrees to 100 degrees. One patient had a superficial wound infection which settled after a course of oral antibiotics. None developed an increased extension lag after surgery and all were very satisfied with the results. Quadricepsplasty is a useful procedure for stiffness of the knee after femoral lengthening which has not responded to physiotherapy.
authors.affiliation: Hospital for Sick Children, London, England, UK.
authors.forename: H S
authors.initials: HS
authors.lastname: Hosalkar
authors.forename: S
authors.initials: S
authors.lastname: Jones
authors.forename: M
authors.initials: M
authors.lastname: Chowdhury
authors.forename: J
authors.initials: J
authors.lastname: Hartley
authors.forename: R A
authors.initials: RA
authors.lastname: Hill
mesh_terms: D000293:Adolescent; D001852:Bone Lengthening / Q000009:adverse effects*; D002648:Child; D003286:Contracture / Q000209:etiology / Q000601:surgery*; D005260:Female; D005269:Femur / Q000002:abnormalities* / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D018889:Ilizarov Technique / Q000009:adverse effects; D007719:Knee Joint / Q000503:physiopathology* / Q000601:surgery; D007870:Leg Length Inequality / Q000601:surgery*; D008297:Male; D018482:Muscle, Skeletal / Q000601:surgery*; D016059:Range of Motion, Articular