Treatment of knee flexion contracture with Ilizarov technology after burns_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHANG Ziyang , DOU Xuejiao ^△ ,  WEI Zairong

Department of Burn and Plastic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi Guizhou, 563000, P.R.China;

Corresponding?author：

WEI Zairong, Email: zairongwei@sina.com

Keywords：

Burns; scar contracture; Ilizarov technique; knee joint

DOI：

10.7507/1002-1892.201805095

Video：

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Objective To summarize the effectiveness of Ilizarov technique in the correction of flexion contracture deformity of the knee after burn. Methods Between April 2012 and July 2017, Ilizarov technique was used to treat 14 cases (17 knees) of knee flexion contracture patients. There were 11 males (13 knees) and 3 females (4 knees), with an age of 20-48 years (mean, 37 years). The duration of scar formation was 8 months to 24 years (mean, 5 years). The scar ranged from the upper part of the thigh, down to the middle part of the leg, from both sides to the inside and outside of the popliteal fossa, without ulceration. The area after scar contracture was 12 cm×10 cm to 30 cm×22 cm. Preoperative total activity of motion (TAM) was 30-115° (mean, 69°). There were 4 cases in wheelchair, 5 cases walking with double crutches, 3 cases with limp, and 2 cases with half squat walking. According to the knee function evaluation criteria by QIN Sihe, the preoperative knee function was fair in 3 knees, poor in 5 knees, and very poor in 9 knees. Results All patients were followed up 6 months to 5 years (mean, 2 years). No local skin necrosis, needle tract infection, limb numbness, and other complications occurred. Knee flexion deformities were all corrected. The postoperative TAM was 70-145° (mean, 125°). All patients were able to walk with plantar weight-bearing, and their gait improved when compared with that before operation. Five cases could walk without a crutch and only slightly claudication after operation. At last follow-up, according to the knee function evaluation criteria, the results were excellent in 9 knees, good in 5 knees, and fair in 3 knees, all were significantly improved when compared with that before operation (Z=–3.677,P=0.000). Conclusion Ilizarov technique has the advantages of minimally invasive, safe, and easy to operate for the treatment of flexion contracture deformity of the knee after burn.

Citation： ZHANG Ziyang, DOU Xuejiao, WEI Zairong. Treatment of knee flexion contracture with Ilizarov technology after burns. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(10): 1271-1274. doi: 10.7507/1002-1892.201805095 Copy

1.	秦泗河. 脊髓灰質炎后遺癥外科治療. 北京: 人民衛生出版社, 2006: 116-117.
2.	Balci HI, Kocaoglu M, Eralp L, et al. Knee flexion contracture in haemophilia: treatment with circular external fixator. Haemophilia, 2014, 20(6): 879-883.
3.	秦泗河, 陳建文, 夏和桃, 等. Ilizarov 技術矯治重度膝關節屈曲攣縮畸形的臨床研究. 中國矯形外科雜志, 2007, 15(8): 583-586.
4.	Reitenbach E, R?dl R, Gosheger G, et al. Deformity correction and extremity lengthening in the lower leg: comparison of clinical outcomes with two external surgical procedures. Springerplus, 2016, 5(1): 2-9.
5.	孫磊, 秦泗河, 寧志杰, 等. Ilizarov 外固定器矯正膝關節畸形. 中華骨科雜志, 2012, 32(3): 211-216.
6.	Fernandes RM, Mendes MD, Amorim R, et al. Surgical treatment of neglected clubfoot using external fixator. Rev Bras Ortop, 2016, 51(5): 501-508.
7.	郭保逢, 秦泗河, 任龍喜, 等. Ilizarov 技術治療下肢血管瘤致屈膝畸形. 中國矯形外科雜志, 2016, 24(17): 1570-1574.
8.	秦泗河, 夏和桃. 改良 Ilizarov 技術矯治兒童膝關節重度屈曲畸形. 中華骨科雜志, 2002, 22(2): 125-126.
9.	Mahapatra S, Abraham VT. A comparative analysis of the two most common surgical exposures for clubfoot. Int Surg J, 2016, 3(3): 1283-1286.
10.	秦泗河, 陳建文, 鄭學建, 等. 膝關節牽伸技術治療先天性多發性關節攣縮癥屈膝畸形. 中華外科雜志, 2004, 42(16): 993-996.
11.	Solignac N, Vialle R, Thevenin-Lemoine C, et al. Popliteal pterygium knee contracture: treatment with the Ilizarov technique. Orthop Traumatol Surg Res, 2009, 95(3): 196-201.
12.	梁超, 劉躍華, 史鵬飛, 等. Ilizarov 牽伸器治療創傷性膝關節伸直位僵硬. 中國矯形外科雜志, 2018, 26(5): 463-467.
13.	依力哈木江·吾斯曼, 買買提明·賽依提, 阿不地哈比爾·阿不拉, 等. 應用 Ilizarov 與 Orthofix 外固定架行脛骨截骨延長后發生的足下垂. 中國組織工程研究, 2016, 20(22): 3279-3286.
14.	張子陽, 臧建成, 秦泗河. Ilizarov 技術治療燒傷后馬蹄內翻足畸形. 中國修復重建外科雜志, 2018, 32(2): 178-181.
15.	Dimeglio A, Canavese F. The French functional physical therapy method for the treatment of congenital clubfoot. J Pediatr Orthop B, 2012, 21(1): 28-39.
16.	?vehlík M, Floh U, Steinwender G, et al. Ponseti method is superior to surgical treatment in clubfoot-Long-term, randomized, prospective trial. Gait Posture, 2017, 58(2): 346-351.
17.	Matuszewski L, Gil L, Karski J. Early results of treatment for congenital clubfoot using the Ponseti method. Eur J Orthop Surg Traumatol, 2012, 22(5): 403-406.

1. 秦泗河. 脊髓灰質炎后遺癥外科治療. 北京: 人民衛生出版社, 2006: 116-117.
2. Balci HI, Kocaoglu M, Eralp L, et al. Knee flexion contracture in haemophilia: treatment with circular external fixator. Haemophilia, 2014, 20(6): 879-883.
3. 秦泗河, 陳建文, 夏和桃, 等. Ilizarov 技術矯治重度膝關節屈曲攣縮畸形的臨床研究. 中國矯形外科雜志, 2007, 15(8): 583-586.
4. Reitenbach E, R?dl R, Gosheger G, et al. Deformity correction and extremity lengthening in the lower leg: comparison of clinical outcomes with two external surgical procedures. Springerplus, 2016, 5(1): 2-9.
5. 孫磊, 秦泗河, 寧志杰, 等. Ilizarov 外固定器矯正膝關節畸形. 中華骨科雜志, 2012, 32(3): 211-216.
6. Fernandes RM, Mendes MD, Amorim R, et al. Surgical treatment of neglected clubfoot using external fixator. Rev Bras Ortop, 2016, 51(5): 501-508.
7. 郭保逢, 秦泗河, 任龍喜, 等. Ilizarov 技術治療下肢血管瘤致屈膝畸形. 中國矯形外科雜志, 2016, 24(17): 1570-1574.
8. 秦泗河, 夏和桃. 改良 Ilizarov 技術矯治兒童膝關節重度屈曲畸形. 中華骨科雜志, 2002, 22(2): 125-126.
9. Mahapatra S, Abraham VT. A comparative analysis of the two most common surgical exposures for clubfoot. Int Surg J, 2016, 3(3): 1283-1286.
10. 秦泗河, 陳建文, 鄭學建, 等. 膝關節牽伸技術治療先天性多發性關節攣縮癥屈膝畸形. 中華外科雜志, 2004, 42(16): 993-996.
11. Solignac N, Vialle R, Thevenin-Lemoine C, et al. Popliteal pterygium knee contracture: treatment with the Ilizarov technique. Orthop Traumatol Surg Res, 2009, 95(3): 196-201.
12. 梁超, 劉躍華, 史鵬飛, 等. Ilizarov 牽伸器治療創傷性膝關節伸直位僵硬. 中國矯形外科雜志, 2018, 26(5): 463-467.
13. 依力哈木江·吾斯曼, 買買提明·賽依提, 阿不地哈比爾·阿不拉, 等. 應用 Ilizarov 與 Orthofix 外固定架行脛骨截骨延長后發生的足下垂. 中國組織工程研究, 2016, 20(22): 3279-3286.
14. 張子陽, 臧建成, 秦泗河. Ilizarov 技術治療燒傷后馬蹄內翻足畸形. 中國修復重建外科雜志, 2018, 32(2): 178-181.
15. Dimeglio A, Canavese F. The French functional physical therapy method for the treatment of congenital clubfoot. J Pediatr Orthop B, 2012, 21(1): 28-39.
16. ?vehlík M, Floh U, Steinwender G, et al. Ponseti method is superior to surgical treatment in clubfoot-Long-term, randomized, prospective trial. Gait Posture, 2017, 58(2): 346-351.
17. Matuszewski L, Gil L, Karski J. Early results of treatment for congenital clubfoot using the Ponseti method. Eur J Orthop Surg Traumatol, 2012, 22(5): 403-406.

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Treatment of knee flexion contracture with Ilizarov technology after burns

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