A Modified Thompson Quadricepsplasty for Extension Contracture Resulting From Femoral and Periarticular Knee Fractures

作者：Ebbrahimzadeh Mohammad H^*; Birjandi Nejad Ali; Ghorbani Said; Khorasani Mohammad Reza

来源：Journal of Trauma-Injury Infection and Critical Care, 2010, 68(6): 1471-1475.

DOI：10.1097/TA.0b013e3181bdcdec

• Knee stiffness
• Quadricepsplasty
• Knee extension contracture
• Knee surgery
• Thompson quadricepsplasty
• Knee fracture
• Distal femoral fracture
• Iran

Background: The lack of knee flexion is an increasingly recognized complication of femoral and periarticular knee fractures. This is a significant challenge for both surgeon and patients.
Methods: This article reports the clinical outcomes of 40 knees in 40 patients who underwent a modified Thompson quadricepsplasty. They were 36 men and 4 women. We performed a modified Thompson quadricepsplasty for all patients without excision of vastus intermedius even in scarred cases. The definitive flexion gain was classified recording to Judet criteria; excellent defined as > 100 degrees, good when > 80 degrees and < 99 degrees, fair when > 50 degrees and < 79 degrees, and poor when < 50 degrees.
Results: Patients were operated on average 6.9 months +/- 3.6 months (range, 4-24 months) after first initial surgery. Average follow-up was 17.5 months (range, 12-24 months). According to Judet criteria, 9 patients (22.5%) achieved excellent, 27 patients (67.5%) good, 2 patients (5%) fair, and 2 patients (5%) poor. Final average flexion arc improvement was 65 degrees +/- 25.99 degrees with a range between 5 degrees and 100 degrees. Our complications included two cases (5%) of superficial infection and one case (2.5%) with patellar fracture. In patients who had preoperative extension lag, we did not achieve a significant improvement of the extension lag (p = 0.062).
Conclusion: Modified Thompson quadricepsplasty is a promising procedure with satisfactory results. It provides significantly results if it is performed earlier and in more severe extension contracture.

• 出版日期2010-6