Cast-rod construct for gradual correction of fixed knee flexion deformities in young children with arthrogryposis: Technical note and preliminary results

Abstract

INTRODUCTION: Fixed knee flexion deformities (FKFDs) are common in children with arthrogryposis, yet their management in younger children is underreported. MATERIAL AND METHOD: This study describes a non-invasive cast-rod construct for the gradual correction of FKFDs secondary to arthrogryposis. RESULTS: This study presents preliminary results from 18 knees in 12 patients under four years old (median age at 30 mo, 18-48). The median knee flexion contracture angle improved from 54.5 degrees (27-90) to 10 degrees (0-30) after cast removal, (p < 0.05). Treatment lasted for a median of 32 days (21-68). At a median eight months follow up (3-47), the angle increased to a median of 28 degrees (10-35), which remained significantly lower than the initial angle, (p < 0.05). CONCLUSION: The cast-rod construct appears to be an effective tool for improving FKFDs in young children with arthrogryposis: however, further research with extended follow-up is needed to assess the long-term durability of these outcomes. LEVEL OF EVIDENCE: IV; Case series.