Hamstring transfer for quadriceps paralysis in post polio residual paralysis.

Area of Science:

• Orthopedic surgery
• Reconstructive surgery
• Pediatric orthopedics

Background:

• Quadriceps paralysis causes severe knee instability and gait abnormalities.
• Patients compensate with gait aids or altered posture.
• Hamstring transfer is a viable surgical option for quadriceps weakness.

Purpose of the Study:

• To evaluate the outcomes of a modified hamstring transfer technique.
• To assess the efficacy in patients with post-polio residual paralysis and quadriceps weakness.

Main Methods:

• Retrospective analysis of 267 patients undergoing modified hamstring transfer.
• Modified technique involves suturing hamstring tendons under an osteoperiosteal flap on the patella.
• Patients followed for outcomes including knee extension, flexion, and gait improvement.

Main Results:

• 65% of patients achieved excellent results, 15% good, and 20% poor.
• Major complications (e.g., genu recurvatum) occurred in 93 patients.
• Minor complications (e.g., superficial infection) occurred in 10 patients.

Conclusions:

• Modified hamstring transfer is a superior dynamic alternative to supracondylar osteotomy for quadriceps paralysis.
• The flap technique enhances tendon fixation and patellar fulcrum effect for improved knee stability.
• This procedure offers significant functional improvement for patients with paralytic knee instability.