Surgical Management of Quadriceps Contracture

Introduction Quadriceps contracture is a common condition where quadriceps is contracted due to various causes. The contracture may occur in one or more components of the muscle. Since the quadriceps femoris is the main active extensor of the knee, contracture of this muscle causes extension contracture of the knee thereby producing a stiff extended knee wherein the muscle fails to elongate enough to allow flexion. This results in severe disability and hence it is important to obtain as much as flexion as possible without impairing the extending power of the quadriceps muscle. Materials and Methods Our study included 20 patinets with quadriceps contracture. Thompsons quadricepsplasty alone was done in 6 cases and Thompsons quadricepsplasty plus Benneetts V-Y plasty done in 14 cases. The procedure was done depending upon the structures involved. Extension lag was minimal in cases where only thompsons quadricepsplasty was done. The extension lag recovered gradually in cases with Bennetts V-Y plasty was done. Conclusion Quadriceps contracture is a common and very disabling condition. Various surgical options are available based on location of contracture, age, cause and duration of the contracture. Better results were obtained whenever surgery was done early. Physiotherapy is the main stay in the post operative management not only in gaining maximum flexion but also in regaining active extension.