Clinical trial NCT04911686: Correction of Fixed Knee Flexion Deformity in Children Distraction by Cast Wedge and Rod Lengthening
Official title: Correction of Fixed Knee Flexion Deformity in Children Distraction by Cast Wedge and Rod Lengthening
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Flexion Deformity of Knee
Lead sponsor: Assiut University
Sponsor class: OTHER
First posted: 2021-06-03
Enrollment: 20
Sex: ALL
Maximum age (years): 4
Standard ages: CHILD
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Children with FKFD Age \< 4 years.

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.

Eligibility criteria: 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.

Primary outcomes:
measure: Correction of fixed knee flexion deformities in children using cast and rod distraction
timeFrame: baseline
Secondary outcomes:
measure: Correction of fixed knee flexion deformities in children using cast and rod distraction
timeFrame: baseline
Other outcomes:
Locations:
Study officials:
affiliation: Analysis and interpretation of data
name: Mohamed Khaled Hassan Ahmed, professor
role: STUDY_DIRECTOR
References:
citation: Balci HI, Kocaoglu M, Eralp L, Bilen FE. Knee flexion contracture in haemophilia: treatment with circular external fixator. Haemophilia. 2014 Nov;20(6):879-83. doi: 10.1111/hae.12478. Epub 2014 Aug 21.
citation: Spiro AS, Stenger P, Hoffmann M, Vettorazzi E, Babin K, Lipovac S, Kolb JP, Novo de Oliveira A, Rueger JM, Stuecker R. Treatment of fixed knee flexion deformity by anterior distal femoral stapling. Knee Surg Sports Traumatol Arthrosc. 2012 Dec;20(12):2413-8. doi: 10.1007/s00167-012-1915-8. Epub 2012 Feb 4.