Quadriceps contusions. West Point update.

A 3 year study of 117 quadriceps contusions in West Point cadets was undertaken to document the effectiveness of a three-phased therapy program to return these young athletes to full activity with a normal knee range of motion and without recurrence of injury. The treatment protocol of this study was modeled after the 1973 West Point study of Jackson and Feagin with two major changes: 1) resting the injured leg in flexion (versus extension) and 2) emphasizing early flexion exercises (versus extension). Classification of contusions was based on knee range of motion at 12 to 24 hours after the injury (mild, greater than 90 degrees; moderate, 45 degrees to 90 degrees; severe, less than 45 degrees). The average disability time was 13 days for mild, 19 days for moderate, and 21 days for severe contusions. Myositis ossificans developed in 9% of cadets and was associated with five risk factors (knee motion less than 120 degrees, injury occurring during football, previous quadriceps injury, delay in treatment greater than 3 days, and ipsilateral knee effusion.