Modified judet quadricepsplasty and Ilizarov frame application for stiff knee after femur fractures

Limited knee range of motion caused by posttraumatic arthrofibrosis after periarticular fracture remains a challenging problem. Traditionally, Judet or Thompson quadricepsplasty has been performed for severe stiff knee after distal femoral fracture. However, these procedures have a high rate of complications such as skin necrosis, wound dehiscence, and extension lag caused by long incisions and extensive surgery. The present study reports on a novel method that combines modified quadricepsplasty and the Ilizarov frame for management of severe stiff knee after metadiaphyseal fracture around the knee joints. This technique was applied in 10 patients over a 7-year period by one surgeon. The treatment resulted in improved knee range of motion without rebound phenomenon, which is a frequent problem when using either the Ilizarov frame or quadricepsplasty alone.