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Popliteal pterygium knee contracture: treatment with the Ilizarov technique.
Orthop Traumatol Surg Res. 2009 May; 95(3):196-201.OT

Abstract

INTRODUCTION

Various treatment options are in use to address severe knee flexion contractures in children. Their success depends on an adequate selection of the proper one applying to each individual anatomical situation.

HYPOTHESIS

Applied to limb deformity, the Ilizarov technique combines progressive correction, to joint structures flexibility restitution in case of severe knee flexion contracture. We review a continuous series of popliteal pterygium syndrome patients managed with this technique.

PATIENTS AND METHODS

Medical records of eight children (11 knees), consecutively treated between 1986 and 2007, were reviewed. Knee flexion ranged from 40 to 120 degrees. Contracture (> 90 degrees) was extremely severe in 10 cases. Progressive correction was gained by Ilizarov external fixation. Complications during and following articular chain distraction-lengthening were noted. Follow-up ranged from 1 to 21 years.

RESULTS

Surgical realignment was rendered particularly complex by the popliteal cutaneous band itself, partly responsible of the joint stiffness and sciatic nerve shortening. Deformities were corrected by the Ilizarov technique. Complete extension was obtained in all cases. In six cases, flexion contracture reccurrence required to repeat the correction, using the same technique, at a mean interval of 3-4 years. During follow-up, four evolutive partial posterior tibial dislocations and one complete dislocation were diagnosed, all associated with recurrence of the flexion contracture.

LEVEL OF EVIDENCE

Level IV. Therapeutic Study.

Authors+Show Affiliations

Service de chirurgie orthopédique et réparatrice de l'enfant, hôpital d'Enfants Armand-Trousseau, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19410531

Citation

Solignac, N, et al. "Popliteal Pterygium Knee Contracture: Treatment With the Ilizarov Technique." Orthopaedics & Traumatology, Surgery & Research : OTSR, vol. 95, no. 3, 2009, pp. 196-201.
Solignac N, Vialle R, Thévenin-Lemoine C, et al. Popliteal pterygium knee contracture: treatment with the Ilizarov technique. Orthop Traumatol Surg Res. 2009;95(3):196-201.
Solignac, N., Vialle, R., Thévenin-Lemoine, C., & Damsin, J. P. (2009). Popliteal pterygium knee contracture: treatment with the Ilizarov technique. Orthopaedics & Traumatology, Surgery & Research : OTSR, 95(3), 196-201. https://doi.org/10.1016/j.otsr.2009.01.004
Solignac N, et al. Popliteal Pterygium Knee Contracture: Treatment With the Ilizarov Technique. Orthop Traumatol Surg Res. 2009;95(3):196-201. PubMed PMID: 19410531.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Popliteal pterygium knee contracture: treatment with the Ilizarov technique. AU - Solignac,N, AU - Vialle,R, AU - Thévenin-Lemoine,C, AU - Damsin,J-P, Y1 - 2009/05/01/ PY - 2008/02/01/received PY - 2008/12/15/revised PY - 2009/01/12/accepted PY - 2009/5/5/entrez PY - 2009/5/5/pubmed PY - 2009/8/14/medline SP - 196 EP - 201 JF - Orthopaedics & traumatology, surgery & research : OTSR JO - Orthop Traumatol Surg Res VL - 95 IS - 3 N2 - INTRODUCTION: Various treatment options are in use to address severe knee flexion contractures in children. Their success depends on an adequate selection of the proper one applying to each individual anatomical situation. HYPOTHESIS: Applied to limb deformity, the Ilizarov technique combines progressive correction, to joint structures flexibility restitution in case of severe knee flexion contracture. We review a continuous series of popliteal pterygium syndrome patients managed with this technique. PATIENTS AND METHODS: Medical records of eight children (11 knees), consecutively treated between 1986 and 2007, were reviewed. Knee flexion ranged from 40 to 120 degrees. Contracture (> 90 degrees) was extremely severe in 10 cases. Progressive correction was gained by Ilizarov external fixation. Complications during and following articular chain distraction-lengthening were noted. Follow-up ranged from 1 to 21 years. RESULTS: Surgical realignment was rendered particularly complex by the popliteal cutaneous band itself, partly responsible of the joint stiffness and sciatic nerve shortening. Deformities were corrected by the Ilizarov technique. Complete extension was obtained in all cases. In six cases, flexion contracture reccurrence required to repeat the correction, using the same technique, at a mean interval of 3-4 years. During follow-up, four evolutive partial posterior tibial dislocations and one complete dislocation were diagnosed, all associated with recurrence of the flexion contracture. LEVEL OF EVIDENCE: Level IV. Therapeutic Study. SN - 1877-0568 UR - https://www.unboundmedicine.com/medline/citation/19410531/Popliteal_pterygium_knee_contracture:_treatment_with_the_Ilizarov_technique L2 - https://linkinghub.elsevier.com/retrieve/pii/S1877-0568(09)00044-9 DB - PRIME DP - Unbound Medicine ER -