Quadricepsplasty for congenital dislocation of the knee and congenital quadriceps contracture

Stéphane Tercier, Hitesh Shah, Benjamin Joseph

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose: We encountered problems with the Curtis and Fisher technique of quadricepsplasty for congenital quadriceps contracture, including wound dehiscence, insufficient lengthening of the quadriceps and instability of the knee. We modified the operative technique to address these three problems. We undertook this study to evaluate the results of the modified technique of quadricepsplasty to determine if we succeeded in overcoming these limitations of the original technique. Methods: Twenty children (33 knees) underwent the modified Curtis and Fisher quadricepsplasty through a lateral incision; a long tongue of the rectus femoris was raised and the vasti mobilised without dividing the lateral retinaculae till the collateral ligaments. The children were followed up for a mean period of 63 months and evaluated. The healing of the wound, active and passive range of motion (ROM) of the knee, the stability of the knee, quadriceps power and knee function were assessed. Results: Primary wound healing occurred in 32 of 33 knees. Adequate lengthening of the quadriceps sufficient to facilitate knee flexion to 90° was possible. Considerable improvement in the ROM was noted. In non-syndromic congenital dislocation of the knee (CDK), the quadriceps power was Grade 5, but minor degrees of extensor lag was noted. In a proportion of patients, minor degrees of joint instability was present. The majority of children were community walkers. The overall results were better in non-syndromic CDK than in children with arthrogryposis, but differences of some variables were not significant. Conclusion: The modifications to the original Curtis and Fisher technique overcame the specific problems they were expected to avoid.

Original languageEnglish
Pages (from-to)397-410
Number of pages14
JournalJournal of Children's Orthopaedics
Volume6
Issue number5
DOIs
Publication statusPublished - 19-09-2012

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Knee Dislocation
Contracture
Knee
Articular Range of Motion
Wound Healing
Arthrogryposis
Walkers
Joint Instability
Collateral Ligaments
Quadriceps Muscle
Tongue
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Orthopedics and Sports Medicine

Cite this

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abstract = "Purpose: We encountered problems with the Curtis and Fisher technique of quadricepsplasty for congenital quadriceps contracture, including wound dehiscence, insufficient lengthening of the quadriceps and instability of the knee. We modified the operative technique to address these three problems. We undertook this study to evaluate the results of the modified technique of quadricepsplasty to determine if we succeeded in overcoming these limitations of the original technique. Methods: Twenty children (33 knees) underwent the modified Curtis and Fisher quadricepsplasty through a lateral incision; a long tongue of the rectus femoris was raised and the vasti mobilised without dividing the lateral retinaculae till the collateral ligaments. The children were followed up for a mean period of 63 months and evaluated. The healing of the wound, active and passive range of motion (ROM) of the knee, the stability of the knee, quadriceps power and knee function were assessed. Results: Primary wound healing occurred in 32 of 33 knees. Adequate lengthening of the quadriceps sufficient to facilitate knee flexion to 90° was possible. Considerable improvement in the ROM was noted. In non-syndromic congenital dislocation of the knee (CDK), the quadriceps power was Grade 5, but minor degrees of extensor lag was noted. In a proportion of patients, minor degrees of joint instability was present. The majority of children were community walkers. The overall results were better in non-syndromic CDK than in children with arthrogryposis, but differences of some variables were not significant. Conclusion: The modifications to the original Curtis and Fisher technique overcame the specific problems they were expected to avoid.",
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Quadricepsplasty for congenital dislocation of the knee and congenital quadriceps contracture. / Tercier, Stéphane; Shah, Hitesh; Joseph, Benjamin.

In: Journal of Children's Orthopaedics, Vol. 6, No. 5, 19.09.2012, p. 397-410.

Research output: Contribution to journalArticle

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