Heng Xiang1, Xin Jiang2, Mingxing Peng3, Lijun Liu3. 1. Department of Orthopedics, Mianzhu People's Hospital, Mianzhu Sichuan, 618200, P.R.China. 2. Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China.jiangxin1975@126.com. 3. Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China.
Abstract
OBJECTIVE: To investigate the effectiveness of internal and external lysis combined with Ilizarov external fixation technology for severe knee pathological flexion contracture deformity in children. METHODS: A retrospective analysis was made on 12 children (12 knees) with severe knee pathological flexion contracture deformity who were treated with internal and external lysis and Ilizarov external fixation between August 2012 and January 2017. There were 9 boys and 3 girls with an age of 3-12 years (mean, 8.4 years). There were 8 cases of tuberculosis, 3 cases of haemophilia A, and 1 case of residual deformity after extensive hemangioma drug injection. The disease duration ranged from 5 months to 4 years, with an average of 20.3 months. The degree of knee contracture was (67.42±23.30)°, and the range of motion of knee was (38.33±14.98)°. The preoperative Western Ontario and McMaster University Osteoarthritis Index (WOMAC) score was 78.42±15.57. The complication was observed after operation, and the degree of knee contracture, range of motion, and WOMAC score at 3 months and 1 year after operation were recorded and compared with those before operation. RESULTS: The operations completed successfully in all children. All the 12 cases were followed up 9-24 months (mean, 14.5 months). All incisions healed by first intention after operation. The knee function of all children improved significantly and the weight-bearing walking function of the lower limbs restored. The degree of knee contracture, range of motion, and WOMAC score were significantly improved at 3 months and 1 year after operation (P<0.05), but there was no significant difference between 3 months and 1 year after operation (P>0.05). CONCLUSION: For severe knee pathological flexion contracture deformity in children, application of internal and external lysis combined with Ilizarov external fixation has advantages, such as small trauma, rapid recovery, and early postoperative knee function training, and good effectiveness.
OBJECTIVE: To investigate the effectiveness of internal and external lysis combined with Ilizarov external fixation technology for severe knee pathological flexion contracture deformity in children. METHODS: A retrospective analysis was made on 12 children (12 knees) with severe knee pathological flexion contracture deformity who were treated with internal and external lysis and Ilizarov external fixation between August 2012 and January 2017. There were 9 boys and 3 girls with an age of 3-12 years (mean, 8.4 years). There were 8 cases of tuberculosis, 3 cases of haemophilia A, and 1 case of residual deformity after extensive hemangioma drug injection. The disease duration ranged from 5 months to 4 years, with an average of 20.3 months. The degree of knee contracture was (67.42±23.30)°, and the range of motion of knee was (38.33±14.98)°. The preoperative Western Ontario and McMaster University Osteoarthritis Index (WOMAC) score was 78.42±15.57. The complication was observed after operation, and the degree of knee contracture, range of motion, and WOMAC score at 3 months and 1 year after operation were recorded and compared with those before operation. RESULTS: The operations completed successfully in all children. All the 12 cases were followed up 9-24 months (mean, 14.5 months). All incisions healed by first intention after operation. The knee function of all children improved significantly and the weight-bearing walking function of the lower limbs restored. The degree of knee contracture, range of motion, and WOMAC score were significantly improved at 3 months and 1 year after operation (P<0.05), but there was no significant difference between 3 months and 1 year after operation (P>0.05). CONCLUSION: For severe knee pathological flexion contracture deformity in children, application of internal and external lysis combined with Ilizarov external fixation has advantages, such as small trauma, rapid recovery, and early postoperative knee function training, and good effectiveness.
Authors: Harold J P van Bosse; Eva Pontén; Akifusa Wada; Olga E Agranovich; Bartłomiej Kowalczyk; Ehud Lebel; Hakan Şenaran; Denis V Derevianko; Maxim A Vavilov; Ekaterina V Petrova; Dmitry B Barsukov; Sergey F Batkin; Sharon Eylon; Vladimir M Kenis; Yulia V Stepanova; Dmitry S Buklaev; Guney Yilmaz; Oksana Köse; Svetlana I Trofimova; Fatih Durgut Journal: J Pediatr Orthop Date: 2017 Jul/Aug Impact factor: 2.324