• Mohammad H Ebrahimzadeh, Mohammad H Ebbrahimzadeh, Ali Birjandi-Nejad, Said Ghorbani, and Mohammad Reza Khorasani.
• Department of Orthopedic Surgery, Orthopedic Research Center, Mashad University of Medical Sciences, Mashad, Iran. mebrahimzadeh@partners.org
• J Trauma. 2010 Jun 1; 68 (6): 1471-5.

BackgroundThe lack of knee flexion is an increasingly recognized complication of femoral and periarticular knee fractures. This is a significant challenge for both surgeon and patients.MethodsThis article reports the clinical outcomes of 40 knees in 40 patients who underwent a modified Thompson quadricepsplasty. They were 36 men and 4 women. We performed a modified Thompson quadricepsplasty for all patients without excision of vastus intermedius even in scarred cases. The definitive flexion gain was classified recording to Judet criteria; excellent defined as >100 degrees, good when >80 degrees and <99 degrees, fair when >50 degrees and <79 degrees, and poor when <50 degrees.ResultsPatients were operated on average 6.9 months +/- 3.6 months (range, 4-24 months) after first initial surgery. Average follow-up was 17.5 months (range, 12-24 months). According to Judet criteria, 9 patients (22.5%) achieved excellent, 27 patients (67.5%) good, 2 patients (5%) fair, and 2 patients (5%) poor. Final average flexion arc improvement was 65 degrees +/- 25.99 degrees with a range between 5 degrees and 100 degrees. Our complications included two cases (5%) of superficial infection and one case (2.5%) with patellar fracture. In patients who had preoperative extension lag, we did not achieve a significant improvement of the extension lag (p = 0.062).ConclusionModified Thompson quadricepsplasty is a promising procedure with satisfactory results. It provides significantly results if it is performed earlier and in more severe extension contracture.

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