PERSISTENT POST-TRAUMATIC EXTENSOR CONTRACTURES OF THE KNEE JOINT — KNOWN AND UNKNOWN

Persistent extensor contractures of the knee joint are severe complications that occur after fractures of the femur. Restoration of mobility and function of the knee joint in this pathology is a complex and urgent problem. In a large number of publications, problems of persistent extensor contractures of the knee joint, their etiology, pathogenesis, symptoms, diagnosis and treatment (both conservative and operative), their principles of application, indications and contraindications are studied. The anatomy, physiology, and biomechanics of the knee joint, the extensor muscles of the lower leg, and the true areas of sliding of the joint and around it, which promote free sliding at the knee joint, are considered in detail. This made it possible to identify unexplored issues in such a well-known orthopedic pathology. As the analysis has shown, until this time, no diagnostic criteria have been identified that indicate that the patient has a persistent extensor contracture, which is subject only to surgical treatment. The extensibility of the skin of the anterior surface of the knee joint and thigh has not been studied, and therefore, there has been no suggestion of optimal operative access to the knee joint and the leg extensor muscles. The absence of developed techniques of plastics of the capsule of the knee joint and reliable stitching of the tendons of the head of the quadriceps femoris after mobilization of the knee joint has been established.

All this indicates the need to study and improve the diagnosis and treatment of persistent extensor contracture of the knee joint.