A 25 years old female with limp and a gradually progressive flexion deformity at the knee, being able to walk only on crutches, following septic arthritis of the knee joint during childhood had a fixed flexion deformity of 70 degrees at the knee with a limb shortening of 7cm with evidence of multiple healed previous sinuses and secondary deformities of spine, pelvis and ankle. The soft tissue over the posterior aspect of knee joint was scarred with a degenerated and ankylosed knee joint. A supracondylar anteriorly based closing wedge osteotomy of the femur at the CORA was done to correct the deformity gradually using a long spanning Ilizarov's ring external fixator with corticotomy and sequential lengthening done later. At final follow up at 12 months after completion of treatment apart from pin tract infections the patient had no other complications like residual or recurrence of deformity, delayed consolidation, nonunion, refracture, peroneal nerve injury or hardware failure. Also with satisfactory hip and ankle range of motion and a limb that was pain free and in functional position unaided ambulation was possible. Hence, wedge resection and gradual correction with Ilizarov's technique can achieve desired results without causing any neurovascular complications or soft tissue procedure requirement in a chronic severely flexed ankylosed knee.
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