Correction of severe congenital knee contracture a technique of soft tissue release and femoral shortening

Two cases of children with severe bilateral congenital knee contracture due to arthrogryposis multiplex congenita that were managed by a one-stage operation for correction of their knee contracture are reported. Both had bilateral flexion deformities of the knee of about 140 degrees that prevented them from standing upright or walking. The surgical procedure included a posterior soft tissue release with shortening of the femur, internal fixation and skin grafting. Satisfactory correction was obtained in both patients and they were able to walk independently

Talectomy in congenital idiopathic talipes equinovarus

Ten feet in seven patients with idiopathic congenital talipes equinovarus were treated by talectomy at the orthopedic department, Assiut University Hospital during the period from August 1991 to January 1994. The average age of patients at time of surgery was eight years. All cases, with the exception of one, had recurrent or residual deformities. The average period of follow-up was two years and five months. The operative procedure used was that described by Tachdjian. The results were evaluated using the grading system described by Trumble et al. Correction of deformity of the hind foot was good in eight feet and fair in two. Forefoot correction was good in six feet and poor in four. Over-all assessment was graded as good in eight feet and fair in two. There was marked improvement in the patients' ability to walk after talectomy. Two complications were reported: anterior displacement of the calcareous beneath the tibia and retained talar fragments. No patient had a recurrence of the deformity. Talectomy was found useful in the management of idiopathic club foot with rigid deformities, multiple scars of previous surgeries, impaired circulation or recurrent deformities. It could also be applicable in older children with rigid neglected deformities