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Year : 2016  |  Volume : 2  |  Issue : 2  |  Page : 102-107

Gradual correction of knee flexion contracture using external fixation

1 Department of Orthopedics, Icahn School of Medicine at Mount Sinai, New York, USA
2 Limb Lengthening and Complex Reconstruction Service, Hospital for Special Surgery, Weill Cornell Medical College, New York, USA
3 Limb Lengthening and Complex Reconstruction Service, Hospital for Special Surgery, Weill Cornell Medical College, New York, NY, USA

Correspondence Address:
Ettore Vulcano
Icahn School of Medicine at Mount Sinai, 5 E 98th St., New York, NY 10029
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2455-3719.190712

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Introduction: Knee flexion contracture (KFC) is a debilitating condition that may affect patients with neurogenic conditions, congenital deformities, posttraumatic deformities, and after total knee replacement. The recurrence rate of the deformity following either operative or nonoperative treatment remains high. The aim of the present study is to assess clinical outcomes of patients with KFCs and associated ankle equinus using gradual correction with a circular external fixator (CEF). Methods: Twenty-one patients with knee flexion contraction were treated using a CEF. Seven patients were also simultaneously treated for ankle equinus. All but two patients underwent a combination of open or arthroscopic knee arthrolysis, distal hamstrings lengthening, and gastrocsoleus release. The CEF was applied to match the residual deformity, following the minimal incision soft-tissue release. Results: Mean follow-up was 13 months. The mean range of motion (ROM) at final follow-up was −10° extension, 64° flexion, 9° ankle dorsiflexion, and 29° ankle plantar flexion. The difference between preoperative and postoperative ROMs was statistically significant (P < 0.05). Discussion: The present study suggests that gradual distraction using a CEF is a safe and effective technique in the management of KFC and concurrent ankle equinus. It is crucial to maintain the postoperative correction with braces for at least 1-3 months, depending on the severity of the condition.

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