MECHANICAL DISTRACTION FOR TREATMENT OF SEVERE KNEE FLEXION CONTRACTURES

Ten patients (14 knees) with severe knee flexion contractures were tre ated by gradual mechanical distraction using either the Ilizarov or Or thofix external fixator. Range of motion improved from an average flex ion contracture of 60 degrees before surgery to 16 degrees at the foll ow-up evaluation. Range of motion results were graded good or excellen t in five knees, fair in two knees, and poor in three knees. Average t otal are of motion remained essentially unchanged when comparing the p reoperative (59 degrees) with the follow-up results (63 degrees). Howe ver, the functional position of this are improved significantly. Probl ems encountered included a ''rebound'' phenomena after frame removal, with loss of the temporarily increased total are of motion. The role o f hamstring tenotomy and radical posterior knee release remains unclea r.