Clinique universitaire de chirurgie pédiatrique/CNHU-HKM, 02 BP 8229, Cotonou, Benin.
Orthop Traumatol Surg Res. 2013 Nov;99(7):817-22. doi: 10.1016/j.otsr.2013.04.014. Epub 2013 Oct 2.
Retractile fibrosis of the quadriceps (RFQ) 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 RFQ treated by distal quadricepsplasty using a modified Thompson-Payr procedure (DQPMTP).
Functional recovery will be good with DQPMTP.
This is a descriptive retrospective 10-year study from 2002 to 2011, including 74 children (88 knees) less than 15 years old, admitted for RFQ and treated in Benin. The types of RFQ were: knee flexion loss of motion 16 cases (18.2%), lag of extension 54 cases (61.4%) and associated genu recurvatum, 18 cases (20.5%). Wasting of the thigh was found in all cases. An associated distal femoral osteotomy was performed to correct a bone deformity in 18 cases (20.5%).
There were 16 cases (18.2%) of poorly looking postoperative scars and 2 cases (2.3%) of fracture during physical therapy. 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°. The quadriceps muscle testing scores were at least 3/5. Results of DQPMTP were good in 80.7% of cases, as shown by mean active knee flexion of 108.5° with normal active extension. The results were satisfactory in 17 cases (19.3%).
DQPMTP has the advantage of cutting a minimum of blood vessels, thus limiting the risk of hematoma. Laterally placed incisions create less tension reducing the risk of skin necrosis. The clinical and radiological results of this series confirm those in the literature. Treatment of RFQ by DQPMTP provides satisfactory functional rehabilitation in patients, which confirms our hypothesis.
Level IV, retrospective study without comparison.
股四头肌回缩纤维化（RFQ）是儿童的身体和社交障碍，通常是由于过去股四头肌肌内注射引起的。本研究的目的是评估使用改良 Thompson-Payr 手术（DQPMTP）进行股四头肌远端成形术治疗 RFQ 的治疗效果。
使用 DQPMTP 治疗 RFQ 可获得良好的功能恢复。
这是一项回顾性描述性研究，时间为 2002 年至 2011 年，共包括 74 名（88 个膝关节）年龄小于 15 岁的儿童，这些儿童因 RFQ 而在贝宁接受治疗。RFQ 的类型为：膝关节活动度丧失 16 例（18.2%），伸展延迟 54 例（61.4%），伴有膝反屈，18 例（20.5%）。所有病例均发现大腿萎缩。为了矫正 18 例（20.5%）骨畸形，对股骨远端进行了联合截骨术。
术后有 16 例（18.2%）外观不佳的手术疤痕和 2 例（2.3%）在物理治疗期间发生骨折。术后平均膝关节屈曲活动度为 77.7°。术后康复后平均屈曲度增加 30.7°，达到 108.5°。股四头肌肌力测试评分为至少 3/5。根据平均主动膝关节屈曲 108.5°和正常主动伸展，80.7%的病例 DQPMTP 结果良好，17 例（19.3%）结果满意。
DQPMTP 的优点是切断的血管最少，从而降低血肿的风险。外侧切口张力较小，降低了皮肤坏死的风险。本系列的临床和影像学结果证实了文献中的结果。DQPMTP 治疗 RFQ 为患者提供了令人满意的功能康复，这证实了我们的假设。
IV 级，无对照的回顾性研究。
