Supracondylar femoral extension osteotomies in the treatment of fixed flexion deformity of the knee.

Thirty-two supracondylar osteotomies of the femur were performed in 20 patients for the correction of fixed flexion deformity of the knee. The patients ranged in age from two to 36 years, with an average follow-up period of 4 1/2 years. Two-thirds of the patients had underlying paralytic disease, either meningomyelocele or polio. Generally, the procedure was employed only in recalcitrant cases in which other more conservative methods had failed. Femoral shortening was the key to success. Although there was a significant complication rate, including fractures, infection, and recurrence, there were no permanent neurologic sequelae or non-unions. All patients eventually obtained satisfactory correction and function. Despite the morbidity, supracondylar extension femoral osteotomy was an effective means of treatment when more conservative methods had failed or when the deformity was particularly severe.