Bil Femoral fractures - 03X04050 Prof J Richardson, Mr S Penna

History 54 yr old electrician RTA 25 yrs ago Bil # femur, Right tibia Left femur open injury required 2 operations. malunion. Current problems pain in both knees, unable to flex his right knee, deformity of left thigh

54 yr old electrician

RTA 25 yrs ago Bil # femur, Right tibia

Left femur open injury required 2 operations. malunion.

Current problems pain in both knees, unable to flex his right knee, deformity of left thigh

Examination Broad based gait Varus deformity left knee Bil significant patello femoral crepitus, mild medial joint tenderness. Right knee – 0 to 70 degrees, Left knee – 0 to 90 degrees. Overall leg length equal but discrepancies at left femur and Right tibia.

Broad based gait

Varus deformity left knee

Bil significant patello femoral crepitus, mild medial joint tenderness.

Right knee – 0 to 70 degrees,

Left knee – 0 to 90 degrees.

Overall leg length equal but discrepancies at left femur and Right tibia.

Xrays

Procedure 1 Bilateral Quadricepsplasty, removal of blade plate and screws left

Bilateral Quadricepsplasty, removal of blade plate and screws left

Post op clinic review Knee flexion up to 110 on left, 100 right

Knee flexion up to 110 on left, 100 right

Xrays Priorities for pa tient now to restore left lower lim b length. What will you do?

Post Op Concerned about movement and clicking at operation site.

Concerned about movement and clicking at operation site.

What are management options now?

What are management options now?