EC Orthopaedics

Objective: Evaluating long-term follow-up of the rectus femoris lengthening for the Payr-Thompson procedure with transferring iliotibial band restores extension function.

Introduction: Retractile fibrosis of the quadriceps is a physical and social handicap in children, and often results from a past history of quadriceps intramuscular injection. The aim of this study was to evaluate the therapeutic results of fibrous quadriceps treated by distal quadricepsplasty using a transferring Iliotibial band (TITB) regain knee extension function.

Materials and Methods: This is a descriptive retrospective 21 year study from 2003 to 2020, including 103 children (113 knees) less than 9 years old. Clinical were: all of Patients knee flexion loss of motion 113 (100%), without associated Genu recurvatum or Dislocation of the patella. Quadricepsplasty with Payr or Thonpson procedure, and reconstruction knee function by transferring Iliotibial band.

Results: The pre-operative range of flexion varied from 5° to 32° with a mean range of 22.5°. The post-operative range was 75° to 140°. The improvement in the range of flexion varied from 5° to 140° with a mean gain of 95°. At the final follow-up, the mean active flexion was 123.5° (85 to 140). The final mean gain in movement was 97.6° (25 to 135). The mean pre-operative ROM was 37.9° (0° to 35°). The mean ROM achieved at operation was 115.9° (75° to 140°). Mean flexion ROM after surgery was 77.7°. Mean flexion increased from 77.7° to 108.5° following postoperative rehabilitation or a mean gain of 30.7°. Accepted result 40 (74.1%) in Variant 1; 59 (100%) in Variant 2; 109 (96.5%) in all patients Postoperative results were more acceptable for V2 than V1 (P-value: 0.0000118).

Conclusion: Quadriceps contracture is a condition quadriceps is contracted due to various causes. Various surgical options are available based on location of contracture, age, cause and duration of the contracture. Transferring Iliotibial band to quadriceps after quadricepsplasty.

 Keywords: Retractile Fibrosis of the Quadriceps; Plasty; Child; Quadriceps Contracture; Transferring Iliotibial Band

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