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

Abstract

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 degrees +/- 24.73 degrees, 122.60 degrees +/- 10.22 degrees, 99.63 degrees +/- 16.52 degrees,and 100.74 degrees +/- 15.67 degrees, respectively. The mean ROM value at various stages was not similar(P<0.001). The mean changes in the ROM were 79.2 degrees +/- 24.6 degrees and 62.1 degrees +/- 19.7 degrees 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.