Correction of Fixed Knee Flexion Deformity in Children Distraction by Cast Wedge and Rod Lengthening

• Conditions: Flexion Deformity of Knee

• Registration Number: NCT04911686
• Lead Sponsor: Assiut University

Brief Summary

The aim of our study is to produce gradual correction of FKFD in younger children.

Detailed Description

Management of pediatric fixed knee flexion deformities (FKFD) has always been a challenge for orthopedic surgeons. They occur due to a variety of causes, including cerebral palsy, arthrogryposis, spina bifida, trauma, and many others. The deleterious effects of FKFD include instability of gait and balance, exhaustion of extensor mechanism, and anterior knee pain, which together produce marked limitation of the activities of daily living in affected children .

Many options have been proposed for the correction of FKFD, with each having its pros and cons. Hamstring release and posterior capsulotomy are frequently used. However, extensive soft tissue release may be needed to treat severe deformities with the risk of neurovascular compromise and genu recurvatum. Supracondylar extension osteotomy with patellar tendon advancement requires postoperative non-weight bearing for at least three weeks and is associated with risk of neurovascular damage and coronal plane deformities and it is mostly used in older children and adolescent . Gradual distraction by ring fixators may be complicated by pin tract problems, fractures, and recurrence .

Our study entails the application of a simple method for correction of FKFD in younger children using a simple cast distraction technique. This conservative method aims at avoiding the complications of surgery in children while achieving a reasonable amount of correction.

Study Timeline

• Status Verified: 2021-03
• Study First Submitted: 2021-05-28
• Study First Submitted QC: 2021-05-28
• Last Update Submitted: 2021-05-28
• Study Start: 2021-06-01
• Study First Posted: 2021-06-03
• Last Update Posted: 2021-06-03
• Primary Completion: 2023-03-01
• Study Completion: 2024-03-01

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 20

Inclusion Criteria

1. Children with FKFD.
2. Age < 4 years.
3. FKFD due to congenital, traumatic, neuromuscular, infections, metabolic disorders and skeletal dysplasias.

Exclusion Criteria

• 1. Older children less than 4 years 2. Recent Post-burn contractures and cases with unsuitable skin conditions.

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Correction of fixed knee flexion deformities in children using cast and rod distraction	baseline	Amount of correction of the flexion deformity measured in degrees

Secondary Outcome Measures

Name	Time	Method
Correction of fixed knee flexion deformities in children using cast and rod distraction	baseline	Rate of correction Monitor patients and report on complication like severe knee joint pain or posterior translation of tibia within the study period, pressure ulcers caused by cast indentation.