Correction of Severe Arthrogrypotic Knee Flexion Contractures

A 16 year old female with a pterygium syndrome and bilateral 90° knee flexion contractures walked with a severely crouched gait, which was unsustainably fatiguing. In order to improve her gait efficiency, she was treated with posterior knee releases and application of knee spanning Ilizarov external fixators. The posterior knee releases were performed through medial and lateral incisions, rather than a posterior incision, to make access to the joint capsule safer and to prevent contracting scar. The hinges of the fixator were aligned to prevent posterior tibial subluxation and femoral-tibial impaction at the final extension.