Journal of orthopaedic case reports
October 1, 2026 · via Europe PMC
Management of Severe Knee Flexion Contracture of 140° with Fibrous Ankylosis in a Resource-Limited Setting: A Case Report.
Geneti MB, Gebrehana ZT, Peltzer J, Babst R, Alemayehu AT.
AI summary — for doctors, generated from the abstract only
A 14-year-old with a 140 degree fixed knee flexion contracture regained independent upright walking after a combined osteotomy, soft tissue and gradual distraction strategy in a resource-limited setting.
What was studied
Single case report of a boy with an 8-year contracture and fibrous ankylosis after knee infection surgery, treated with distal femoral osteotomy, acute shortening, soft tissue release, peroneal nerve decompression, rotational skin flap and gradual distraction with a uniplanar dynamic external fixator.
Key findings
- He previously had to crawl for mobility
- After 5 months he had a straight, fused limb that allowed independent upright walking
- Treatment relied on external fixation rather than advanced facilities
Clinical relevance
The case suggests severe, neglected contractures may still be correctable with staged, low-technology methods, trading knee motion for a functional straight limb.
Who should care
Limitations
One patient, short follow-up (5 months reported), outcome was a fused knee, and no functional scores are given in the abstract.
A fused, straight limb enabled walking in this case, but evidence is limited to a single report.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Chronic knee flexion contracture in children is a rare but disabling condition, particularly in low-resource settings where access to rehabilitation and advanced surgical care is limited.
Case report
We report the case of a 14-year-old boy with an 8-year history of fixed knee flexion contracture following previous knee surgery for infection. The patient presented with inability to walk upright and was forced to crawl for mobility. Clinical and radiographic evaluation confirmed severe contracture and distal femoral deformity. A posterolateral approach with distal femoral osteotomy, acute shortening, soft tissue release, peroneal nerve decompression, rotational skin flap, and gradual distraction osteogenesis using a uniplanar dynamic external fixator was performed. After 5 months, the patient achieved a straight, fused limb, enabling independent upright ambulation.
Conclusion
This case demonstrates that complex knee contractures in resource-limited settings can be successfully managed by distal femur osteotomy, acute shortening, uniplanar dynamic external fixation, and soft tissue reconstruction.
DOI
10.13107/jocr.2026.v16.i10.8176
PMID
42851882
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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