Quadriceps contusions: clinical results of immediate immobilization in 120 degrees of knee flexion.
OBJECTIVE
Quadriceps contusions often result in significant time loss and the possibility of myositis ossificans. The objective of this descriptive case series was to document the results of an initial treatment regimen instituted within 10 minutes from the time of the injury.


METHODS
This study was a prospective case series of 47 midshipmen who sustained quadriceps contusions between August 1987 and December 2005 and who were treated identically and followed by serial examinations until the return to unrestricted full athletic activities.


METHODS
United States Naval Academy (USNA), Annapolis, Maryland.


METHODS
USNA midshipmen who sustained quadriceps contusions while participating in sports activities. Inclusion criteria were (1) stated inability at the time of the injury to continue participation and (2) the inability to perform a pain-free, isometric quadriceps contraction and maintain the knee in full extension with a straight leg lift.


METHODS
On diagnosis the knee was passively flexed painlessly to 120 degrees and held continuously in that position for 24 hours. Use of the brace was discontinued at 24 hours and the midshipman was instructed to perform active, pain-free quadriceps stretching several times a day and to perform pain-free isometric quadriceps strengthening exercises as soon as possible. Goals included pain-free knee flexion and quadriceps size and firmness equal to the uninjured side.


METHODS
Average time from the day of the injury to return to unrestricted full athletic activities with no disability.


RESULTS
The average time to return to unrestricted full athletic activities with no disability was 3.5 days (range of 2 to 5 days). Radiographic examination of the first 23 midshipmen at 3 and 6 months following the injury revealed 1 case of myositis ossificans.


CONCLUSIONS
Placing and holding the knee in 120 degrees of flexion immediately following a quadriceps contusion appears to shorten the time to return to unrestricted full athletic activities compared with reports in other studies.
Aronen
John G
JG
Center for Sports Medicine, Saint Francis Memorial Hospital, San Francisco, CA, USA. laronen@san.rr.com
Garrick
James G
JG
Chronister
Raymond D
RD
McDevitt
Edward R
ER
D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000534:rehabilitation*; D003288:Contusions / Q000628:therapy*; D006801:Humans; D007103:Immobilization; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D008889:Military Personnel; D052580:Muscle Stretching Exercises; D018482:Muscle, Skeletal / Q000293:injuries*; D011446:Prospective Studies; D052097:Quadriceps Muscle / Q000293:injuries*; D013178:Sports Medicine; D013997:Time Factors; D014481:United States