Modified Judet's quadricepsplasty plus patellar traction for knee stiffness after femoral fracture surgery.

BACKGROUND

To investigate the clinical effect of modified Judet quadricepsplasty (MJ) combined with patella traction designed by ourselves in the treatment of knee joint rigidity after a femoral fracture.

METHODS

We retrospectively reviewed the clinical data of 21 patients with stiff knee joint after a femoral fracture treated by modified Judet quadricepsplasty combined with patella traction designed by the author from May 2014 to January 2017. The age at revision surgery was 20-57 (36 ± 12) years. The time between fracture fixation to quadricepsplasty was five to 23 (15 ± 5) months, and the follow-up was 11-32 (18 ± 6) months. Pre-operative, intra-operative, post-operative and final follow-up range of motion (ROM), the total traction time, and complications were assessed. The knee joint function was evaluated according to Judet's classification scheme.

RESULTS

Knee ROM was 5-60 (36 ± 13) ° pre-operatively, and 30-80 (53 ± 13) ° after MJ (an increase of 0-30 (17 ± 10)) (p < 0.05). The duration of patellar traction was ten to 14 (11 ± 2) days. Knee ROM after traction device removal was 90-100 (92 ± 3) °, an increase of 10-65 (39-14) ° compared with the ROM after arthrolysis (p < 0.05). The follow-up duration was 11-32 (18 ± 6) months. Knee ROM at final follow-up was 80-130 (104 ± 12) °, an increase of 40-100 (68 ± 16) 8° compared with pre-operatively (p < 0.05), and of - 10-40 (12 ± 13) ° compared with the ROM after traction removal (p < 0.05). Knee function was excellent in 14 cases (67%), good in 6 (28%), and fair in one (5%).

CONCLUSIONS

The MJ plus patellar traction lengthens the contracted quadriceps femoris, thus restoring knee function within a short period of time.