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Managing Flexion Knee Deformity Using a Circular Frame

  • Symposium: Advances in Limb Lengthening and Reconstruction
  • Published:
Clinical Orthopaedics and Related Research

Abstract

Knee flexion deformity can cause marked physical disability. Acute correction, whether nonoperative or operative, may lead to serious complications. We treated 50 patients (71 knees) between 1994 and 2002 with the Ilizarov external fixator. The deformity was gradually corrected using Ilizarov principles. Of the 50 patients, 29 were affected unilaterally and 21 bilaterally. In 15 patients, there were associated deformities. In no patient did we surgically release soft tissues; in two patients with arthrodesed or congenitally fused knees, we performed osteotomy before distraction. All patients were assessed clinically and radiographically. We assessed knee flexion angle, range of motion, stability, presence of pain, and healing index. After a minimum followup of 1 year (mean 3.7 years; range, 1–8 years), 18 of 20 of the preoperatively nonambulatory patients having bilateral surgery could walk at last followup. Complications included pin tract infection in all patients, knee subluxation in three patients, and fracture related to treatment in seven patients. We believe gradual correction using a circular frame an effective method to treat flexion knee contractures. In patients with bilateral deformities, improvement in functional activity may be expected in most patients.

Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Fig. 2A–I

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Authors and Affiliations

  1. Benha Faculty of Medicine, 53, Misr Helwan Agricultural Street, Maadi, Cairo, Egypt

    Gamal Ahmed Hosny MD

  2. El-Minia Faculty of Medicine, Cairo, Egypt

    Mohamed Fadel MD

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  1. Gamal Ahmed Hosny MD
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  2. Mohamed Fadel MD
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Correspondence to Gamal Ahmed Hosny MD.

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Each author certifies that he has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangement, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his institution does not require approval for the human protocol for this investigation and that all the investigations were conducted in conformity with the ethical principles of research.

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Hosny, G.A., Fadel, M. Managing Flexion Knee Deformity Using a Circular Frame. Clin Orthop Relat Res 466, 2995–3002 (2008). https://doi.org/10.1007/s11999-008-0530-y

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  • DOI: https://doi.org/10.1007/s11999-008-0530-y

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