Diz ekstansiyon kontraktürü sonrası quadrisepsplastide fizyoterapinin etkinliği: bir olgu raporu

Öz

Femoral kırık nedeniyle gelişen ekstansiyon kontraktürü ile birlikte diz sertliği günlük yaşam aktivitelerini zorlaştırır ve normal yürüyüş paternini bozar. Quadrisepsplasti cerrahisi fleksiyon hareketinin kaybını gidermek için kullanılan en popüler yöntemlerden biridir. Femoral kırık sonrasında diz ekstansiyon kontraktürü hikayesi olan 59 yaşında erkek hasta çalışmaya dahil edildi. Diz fleksiyon ve ekstansiyonuna ait normal eklem hareket açıklığı (NEH), ağrı seviyesi, Alt Ekstremite Fonksiyonel Skalası ve Kısa Form-36 (KF-36) quadrisepsplasti cerrahisi öncesinde ve cerrahiden sonra 8. haftada değerlendirildi. Fonksiyonel aktiviteleri geliştirmek için quadrisepsplastiye özgü bir rehabilitasyon programı uygulandı. NEH, ağrı ve fonksiyonel sonuçlar rehabilitasyonla birlikte cerrahiden sonra gelişti. Quadrisepsplasti sonrası hastada fonksiyonel sonuçları geliştirmek için, semptomlara yönelik spesifik bir fizyoterapi protokolü uygulanmalıdır.

Anahtar Kelimeler

• M. Quadriceps femoris,Quadricepsplasti,Kontraktür,Fizyoterapi

Effect of physiotherapy after quadricepsplasty for knee extension contracture: a case report

Öz

Knee stiffness with extension contracture due to femoral fracture impedes the activities of daily living and impairs the normal gait pattern. Quadricepsplasty surgery is one of the most popular methods to resolve the lack of the flexion movement. A 59-year-old male patient with a history of knee extension contracture after femoral fracture was included in the study. Knee flexion and extension range of motion (ROM), pain levels, Lower Extremity Functional Scale and Short Form-36 (SF-36) were evaluated before quadricepsplasty surgery and 8th weeks after surgery. A quadricepsplasty-specific rehabilitation program was applied to improve the functional activities. The ROM, pain levels, and functional outcomes improved with the rehabilitation after surgery. A physiotherapy protocol specific to symptoms after quadricepsplasty should be applied to the patient to improve the functional outcomes.

Anahtar Kelimeler

• M. Quadriceps femoris,Quadricepsplasty,Contracture,Physiotherapy

Kaynakça

1. 1. Harato K, Nagura T, Matsumoto H, et al. Knee flexion contracture will lead to mechanical overload in both limbs: a simulation study using gait analysis. Knee. 2008;15(6Suppl):467-472.
2. 2. Trudel G, Laneuville O, Coletta E, et al. Quantitative and temporal differential recovery of articular and muscular limitations of knee joint contractures; results in a rat model. J Appl Physiol. 2014;117:730-737.
3. 3. Dennis DA, The stiff total knee arthroplasty: causes and cures. Orthopedics. 2001;24(9Suppl):901.
4. 4. Mulholland SJ, Wyss UP. Activities of daily living in Non-Western cultures: range of motion requirements for hip and knee joint implants. Int J Rehabil Res. 2001;24:191-198.
5. 5. Kadaba MP, Ramakrishnan HK, Wootten ME. Measurement of lower extremity kinematics during level walking. J Orthop Res. 1990;8 (3Suppl): 383-392.
6. 6. Dhillon M. Extra articular arthroscopic release in post-traumatic stiff knees: a prospective study of endoscopic quadriceps and patellar release. Acta Orthop Belg. 2005;71:197-203.
7. 7. Mahran M, El Batrawy Y, Sala F, et al. M. Quadricepsplasty: a sustained functional achievement in front of a deteriorated flexion gain. Injury. 2014;45(10Suppl):1643-1647.
8. 8. Nicoll EA. Quadricepsplasty the treatment of stiff knee following trauma. Postgrad Med J. 1964;40:521-526.

9. 9. Brazier JE, Harper R, Jones NMB, et al. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ. 1992;305:160-164.
10. 10. Binkley JM, Stratford PW, Lott SA, et al. The lower extremity functional scale (LEFS): scale development, measurement properties, and clinical application. Phys Ther. 1999;79:371-383.
11. 11. Judet R, Judet J, Lagrange J. A technique for freeing the extensor apparatus in cases of stiffness of the knee. Mem Acad Chir. 1956;82:944-947.
12. 12. Merchan EC, Myong C. Quadricepsplasty: the Judet technique and results of 21 posttraumatic cases. Orthopedics. 1992;15(9Suppl):1081-1085.
13. 13. Masse A, Biasibetti A, Demangos J, et al. The Judet quadricepsplasty: long-term outcome of 21 cases. J Trauma. 2006;61:358-362.
14. 14. Bellemans J, Steenwerckx A, Brabants K, et al. The Judet quadricepsplasty: a retrospective analysis of 16 cases. Acta Orthop Belg. 1996;62:79-82.
15. 15. Mistry JB, Elmallah RK, Bhave A, et al. rehabilitative guidelines after total knee arthroplasty: a review. J Knee Surg. 2016;29(3Suppl):201-217.
16. 16. Palmieri-Smith RM, Thomas AC, Wojtys EM. Maximizing quadriceps strength after ACL reconstruction. Clin Sport Med. 2008;27(3Suppl):405-424.