Fixed Knee Flexion Deformities eMedicine Orthopaedics

Description: Children with neuromuscular disorders often manifest fixed knee flexion deformity due to muscle weakness or imbalance. They tend to develop a crouch gait pattern that may prove refractory to physical therapy, bracing, or spasticity management (Botox/baclofen); for those children, surgical management may be indicated. In addition to hamstring recession for contracture, fixed deformities may require posterior capsulotomy or supracondylar osteotomy. Alternatively, or in addition to the above, some surgeons have resorted to external frame distraction. A new concept is to utilize guided growth of the anterior distal femur to achieve safe and gradual correction of the crouch pattern.
Peter M Stevens, MD Updated: Nov 11, 2008