The Judet quadricepsplasty:: Long-term outcome of 21 cases

Background: The lack of knee flexion represents a possible complication in severe femur fractures. In 1956, Judet proposed a quadricepsplasty technique that allowed for a graded release without the disruption of the vastus medialis obliqus, vastus lateralis, or rectus femoris. Methods: This article reports the clinical outcome of 21 cases of Judet quadricepsplasty after an average follow-up of 101.0 months (range, 21-204 months). The definitive flexion gain was classified as excellent, good, fair, or poor. Excellent when > 100 degrees, good when > 80 < 99 degrees, fair when > 50 degrees < 79 degrees, poor when < 50 degrees. The flexion and extension strength were graded from 0 to 5, according to the Daniel's scale. Results: The average strength score was 4.71 in flexion, 4.81 in extension. The average definitive flexion was 95.67 degrees (range, 54-128 degrees) and the average definitive flexion gain was 72.43 degrees (range, 40-122 degrees). When the patients were grouped on the basis of the definitive flexion, excellent results were observed in eight cases (38.10%), were good in nine (42.86%), and fair in four (19.05) with zero poor results. Conclusions: Our experience has shown that, even if first proposed in 1956, the Judet procedure still gives a reproducible amount of good results.