Thompson's quadricepsplasty for stiff knee

Kundu, Zile Singh; Sangwan, SS; Guliani, Gulshan; Siwach, Ramchander; Kamboj, Pradeep; Singh, Raj

doi:10.4103/0019-5413.37004

Cited by 18 publications

(28 citation statements)

References 16 publications

(18 reference statements)

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“…We agree with Gbenou's [55] opinion that when lengthening Quadriceps The proximal tendinous end of the vastus intermedius and the distal portion of the rectus femo-OALib Journal ris tendon are then overlapped and sutured together with the knee in 60˚ of flexion to reduce the risk of creating an extension lag and even in the cases where there was 90˚ peroperative flexion, did not perform V-Y plasty of rectus femoris [21]. According to Wang et al [56] suture elongation plasty was in knee flexion position of 90˚, may result in substantial weakness of the extension mechanism and an extension lag.…”

Section: /20supporting

confidence: 74%

“…Thompson's technique, on the other hand, has inherent weaknesses, such as delayed wound healing, infection, and an extension lag as the rectus femoris is isolated from the rest of the quadriceps through an anterior midline incision [46] [47] which was the main reason for seeking a modification of the technique and Proximal release in the early stage and distal release in the late stage are the recommended treatments [21] (See Table 2). …”

Section: /20mentioning

confidence: 99%

“…Skin dimples at the front and the lateral aspect of the thigh indicated a history of intramuscular injections of antibiotics in early childhood, confirmed by the parents. Knee flexion less than 45˚ causes problems in gait and hindrance in day to day activities [21]. This results in severe disability and individual as a whole especially in country like in Asian and African countries where people sit on floor and squat for various purposes like working in the farms or for toilet.…”

Section: Introductionmentioning

confidence: 99%

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

Hưng¹

2016

OALib

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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.

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confidence: 74%

Section: /20mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Hưng¹

2016

OALib

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“…Some of the patients had their ectopic bone formatted [11,12]. In addition, the patella and its two sides and the expansion of the quadriceps tendon as well as the intercondylar parts are often lighter in intra-articular adhesions, which are different from the pathological changes from orthopedic trauma knee stiffness [13,14]. The vastus intermedius muscle is the most noticeable muscle in soft tissue contracture, and the rupture of the muscle is very prone to fibrosis, resulting in the loss of muscle flexibility.…”

Section: Discussionmentioning

confidence: 99%

Treatment and Rehabilitation of Knee Joints Straight Stiffness After Burns

Tang

et al. 2014

Indian J Surg

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The knee release surgery and postoperative rehabilitation of patients after burns and knee straight stiffness were investigated. Eleven patients were treated for 16 side burns and knee stiffness who consisted of nine males and two females, aged 19 to 54 years (mean=33.2). The duration of the patients' knee stiffness ranged from 8 to 26 months, with an average of 12.6 months. Their preoperative flexion ranged from 5°to 50°, with an average of 26.2°. Their preoperative Hospital for Special Surgery (HSS) knee scores ranged from 46 to 72 points, with an average of 55.8 points. All stiff knees were treated with release surgery, along with total release of intra-articular adhesion and excision of vastus intermedius. After the arthrolysis of the stiff knee joint, the tight skin was completely loose in the adhesions. The soft tissue contracture was not grafted, but the shade fascia was freed to increase skin ductility. All knee joints were released to more than 90°of flexion in the operation, and reversed fascia flaps were used to suture the loss of the deep fascia at the position of flexion of 90°. After the operation, the knee joint was fixed in flexion for 72 h while being actively cared for by early rehabilitation. Subsequently, the patient's skin coverage, joint motion, and joint function recovery were observed. Based on the followup of the patients for the following 16 to 36 months (mean= 25.7), the knee flexion of the patients ranged from 110°to 135°, with an average of 122.2°and 96°increase (P<0.01). Furthermore, the patients had better skin ductility to meet the increase in joint flexion. HSS knee function scores at the end of follow-up ranged from 93 to 100 points, with an average of 97.5 points and an increase of 41.7 points (P<0.01). The joint function improved significantly. The arthrolysis of straight stiff knee joints after burns can ease muscle contracture and free the shade fascia, thus avoiding the need to undergo skin grafting. Short-term fixation of the joints after surgery and active flexion rehabilitation may also be the key to improve skin ductility and joint function of the patients.

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“…Posttraumatic and/or postsurgical knee stiffness is one of the orthopedic complications which is difficult to be treated. [ 1 ]…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Thompson's quadricepsplasty results in patients with knee stiffness resulted from femoral fracture

2017

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Background:Posttraumatic and/or postsurgical knee stiffness is one of the orthopedic complications which is difficult to be treated and can affect individual's life negatively. The aim of this study is to investigate the results of quadricepsplasty in patients with knee stiffness resulted from femoral fracture.Materials and Methods:This is a cross-sectional study on all patients with femoral fracture which has caused knee flexion limitation referred to Kashani and Al-Zahra Hospitals in Isfahan from January 2010 to March 2013. The type and site of fracture, joint extension, and fracture fixation technique were recorded. Moreover, the range of motion (ROM) before surgery, under general anesthesia, and 3- and 6-month postoperation were measured.Results:Among the patients, 13 had a simple fracture (48%) and 14 had a segmental fracture (51.9%). Considering the fracture site, 11, 10, and 6 patients had femoral (40.74%), supracondylar (37.3%), and femoral supracondylar (22.2%) fractures, respectively. The fracture fixation was performed by the plate, external, and Wagner fixation techniques for 24 (88.9%), 2 (7.4%), and 1 (3.7%) patients, respectively. The mean ROM before operation, under general anesthesia, and 3- and 6-month postoperation were determined to be 33.15° ± 24.73°, 122.60° ± 10.22°, 99.63° ± 16.52°, and 100.74° ± 15.67°, respectively. The mean ROM value at various stages was not similar (P < 0.001). The mean changes in the ROM were 79.2° ± 24.6° and 62.1° ± 19.7° in the cases with simple and segmental fractures, respectively. The mean changes in the knee ROM were significantly higher in simple fractures in comparison with the segmental femoral fracture (P = 0.03).Conclusion:We found Thompson's quadricepsplasty may successfully increase the range of knee flexion in knee fracture and also regardless of quadriceps time.

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Thompson's quadricepsplasty for stiff knee

Cited by 18 publications

References 16 publications

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

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

Treatment and Rehabilitation of Knee Joints Straight Stiffness After Burns

Evaluation of Thompson's quadricepsplasty results in patients with knee stiffness resulted from femoral fracture

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