|
Year |
2002 |
|---|---|
|
Question Number |
252 |
|
Category |
Pediatric Orthopaedics |
Question
An 8 year old girl with arthrogryopsis multiplex congenital has a unilateral left knee flexion contracture despite undergoing posterior knee capsulotomy and hamstring releases. The arc of active knee motion measures from 40 to 80 degrees of flexion. If a distal femoral extension osteotomy is performed, what would be the most likely outcome in four years
1) improved knee arc of motion
2) knee ankylosis
3) patella alta
4) recurrence of the knee flexion deformity
5) anterior subluxation of the tibiofemoral joint
Figures
Answer (click for answer)
Preferred Response: 4
The universal result with this procedure is loss of correction. In the reference, the average was 0.9 degrees/ month with a total loss of 22 degrees on average. This correction loss was at the distal femoral physis to shaft angle, not at the joint line. Finally, they did note that all patients did have a significant and lasting improvement in ambulation even with loss of correction.
Reference: DelBello DA, et al: Distal femoral extension osteotomy for knee flexion contracture in patients with arthrogryposis. J Pediatr Orthop 1996; 122-126.