The Iliotibial Band Transfer Restores Extensor Function after Quadricepsplasty for Knee Stiffness

Abstract

Introduction: Retractile fibrosis of the quadriceps is a physical and social handicap in children, and often results from a past history of quadriceps intramuscular injection. The aim of this study was to evaluate the therapeutic results of fibrous quadriceps treated by distal quadricepsplasty using a transferring Iliotibial band (TITB) to prevent kin necrosis by Incision Z-Plasty. Materials and Methods: This is a descriptive retrospective 21-year study from 1984 to 2005, including 103 children (113 knees) less than 9 years old. Clinical were: all of patients knee flexion loss of motion 113 (100%), without associated Genu recurvatum or Dislocation of the patella. Results: The pre-operative range of flexion varied from 5˚ to 32˚ with a mean range of 22.5˚. The post-operative range was 75˚ to 140˚. The improvement in the range of flexion varied from 5˚ to 140˚ with a mean gain of 95˚. At the final follow-up, the mean active flexion was 123.5˚ (85 to 140). The final mean gain in movement was 97.6˚ (25 to 135). The mean pre-operative ROM was 37.9˚ (0˚ to 35˚). The mean ROM achieved at operation was 115.9˚ (75˚ to 140˚). Mean flexion ROM after surgery was 77.7˚. Mean flexion increased from 77.7˚ to 108.5˚ following postoperative rehabilitation or a mean gain of 30.7˚. Author was performed Incision Z-Plasty for 34 knees, all of them (100%) with good result, and without incision necrosis. Conclusion: Quadriceps contracture is a condition quadriceps is contracted due to various causes. Various surgical options are available based on location of contracture, age, cause and duration of the contracture. Transfering Iliotibial band to Quadriceps after Quadripsplasty and Incision Z-Plasty with postoperative good result.