Femoral pseudoarthrosis and knee stiffness: long-term results of a one-stage surgical approach.
BACKGROUND
The objective of this study was to analyze the surgical results of the simultaneous treatment of femoral pseudoarthrosis and knee stiffness using a combined one-stage approach (quadricepsplasty + osteoperiosteal decortications + bone autografting + fracture stabilization).


METHODS
Twelve patients (six men) followed up for a minimum of 10 years and who had undergone surgery for these combined procedures were contacted for evaluation. Their mean age at the time of the surgery was 30 years (standard deviation, SD 15; range 22-65 years), and mean time from initial trauma was 16 months (SD 6, range 10-32 months).


RESULTS
Mean range of motion improved from 10 degrees (SD 9) to 112 degrees (SD 13) postoperatively. Fractures healed in all patients, and improvement in their range of motion was statistically significant (Student's t-test = 31; P <or= 0.0001). Improvement was significantly greater in patients operated at less than 16 months from initial trauma than in those operated at over 16 months (Student's t-test = 2.71; P = 0.02). Improvement was inversely correlated with time interval since disease onset (Pearson correlation = -0.672; P = 0.017). Postoperative recovery was uneventful, and no deaths or severe complications occurred in this series.


CONCLUSIONS
Despite increased tissue handling, blood loss and postoperative morbidity, the simultaneous treatment of femoral pseudoarthrosis and knee stiffness was successful, and results suggested that the earlier a combined approach is used, the better the outcome may be.
Gomes
João L Ellera
JL
School of Medicine, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos, 2350, Bairro Santa Cecília, Porto Alegre, Rio Grande do Sul, 90035-903, Brazil. elleragomes@gmail.com
Ruthner
Roberto P
RP
Moreira
Luiz
L
D000328:Adult; D000368:Aged; D005260:Female; D005264:Femoral Fractures / Q000150:complications / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods*; D011542:Pseudarthrosis / Q000209:etiology / Q000601:surgery*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult