A New Approach to the Management of Fixed Flexion Deformity of the Knee Using Ilizarov’s Principle of Distraction Histogenesis: A Preliminary Communication

Abstract

Fixed flexion deformity (FFD) of the knee causes significant patient disability and is challenging to orthopedic surgeons because of its complexity. A prospective study was conducted using Ilizarov’s principles of distraction neohistogenesis and differential distraction and Ilizarov’s ring fixator for the correction of this deformity in cases with soft-tissue contracture. This was done without any concurrent bony procedures. A prospective, uncontrolled study of 26 patients (39 knees) was conducted over a 4-year period with prior approval from the local institutional review board. Patients with FFD of the knee without bony ankylosis were treated with knee-spanning 4-ring Ilizarov’s frame and gradual differential distraction. All patients showed complete correction of deformity without any significant complications. The results of this uncontrolled study permit the observation that soft-tissue distraction across a joint using Ilizarov’s principle results in soft-tissue lengthening and correction of joint deformity caused by contractures. This technique needs further detailed examination.