The advantages of free tissue transfer in the treatment of posttraumatic stiff knee.

Abstract

Open fractures of the distal femur involving the joint, surrounding ligament, and soft tissues are among the worst types of injuries that may eventually lead to stiff knee. Release procedures have been described as the common treatment option for posttraumatic stiff knee. However, the importance of simultaneously applied free flaps to replace the pliable soft tissue around the knee joint has not been discussed previously. Between 1996 and 2002, nine patients with posttraumatic severe stiff knees were operated on. All patients underwent release procedures, such as scar removal, quadricepsplasty, tendon lengthening, and/or capsulotomy. In addition, free tissue transfers were performed at the same stage as the release procedures to cover the resultant soft-tissue defects or carried out at a secondary stage because of wound-healing problems. The mean follow-up period was 38 months. Complete flap survival was 100 percent. There were no infection or wound-healing problems following free tissue transfer. After satisfactory rehabilitation, acceptable range of motion was regained. Surgical reconstruction of the posttraumatic stiff knee becomes more straightforward with the use of free flaps to cover soft-tissue defects, providing remarkable advantages for postoperative rehabilitation.