Hex-Based Treatment of Extension Contracture of the Knee Joint Formed After a Complex Fracture of the Proximal Tibia

Intra-articular fractures of proximal tibia can lead to a pathological fibroblastic reaction with the formation of intra-articular fibrous tissue, which leads to joint stiffness (Mariani et al. Arthrosc J Arthrosc Related Surg 3(3):313–318, 1997; Huang and Wu, Chang Gung Med J 30(3):263, 2007). To eliminate joint contracture, soft tissue releases are used (Ding and Khan, Biomedicine 9(3):39–45, 2019). However, with a short period of range of motion (ROM) limitation, it is possible to successfully treat contracture without releases, using external fixation (Lee et al., J Orthop Trauma 24(11):709–715, 2010). In the presented case, successful treatment with the use of an orthopedic hexapod Ortho-SUV Frame (OSF) of an extension contracture of the knee joint after a complex intra-articular fracture of the proximal tibia was demonstrated. The “multi-total residual” option of OSF software calculates the change in struts lengths to reproduce the kinematics of movements in the knee joint, including gradual flexion, sliding, and rotation. The period of passive improvement of ROM 5 days and included 5 full flexion-extension cycles: the first cycle was 34 h (1.4 days) and the last cycle – 3 h. As a result, active ROM 130/0/0 was provided.