12 year old male child presented with inability to bend right knee since childhood. Parents and child did not remember the exact time of onset. Patient had difficulty in walking, could not sit cross legged and could not squat. On examination right thigh showed wasting with mild flexion deformity at knee and absence of any knee flexion. Patella was hypo-plastic and high riding on X-ray. Thomson’s Quadriceps Plasty was done in supine position without any tourniquet. Long midline incision was made. Rectus Femoris was freed from the fibrotic VastusIntermidialis, which was excised. Tight medial and lateral bands were released from Rectus. Medial and Lateral Vasti were released and freed from Rectus completely. Full flexion of knee achieved on table with no shortening of Rectus Femoris. Medial and Lateral Vasti were attached to the Rectus proximally and wound closed with subcutaneous and skin sutures over a drain. Knee immobilized in POP slab with knee in 90 degree flexion. Post operatively passive mobilisation was done from 3rd day with POP slab in between exercise. Patient was uncooperative due to pain. Stitches removed after 2 weeks and patient discharged 2 days later. Post op patient is ambulating with approximately 80 degree flexion at knee joint with adequate knee extensor power and manages to sit cross legged.
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Author Name: Lunik Yadu
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Keywords: Quadriceps Contracture of Childhood
ISSN: 2456-4222
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