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  Indian J Med Microbiol
 

Figure 4: Knee flexion contracture with external rotatory subluxation of tibia and dislocated patella after previous femoral lengthening (top). After posterior capsulotomy and relocation of patella, the femur is cut and the bone ends are allowed to overlap as the knee is fully extended. The overlap for extension is marked (middle left). The relocation of the patella tightens the contracted quadriceps. Flexion of the knee further shortens the femur with greater overlap of the bone ends. This greater overlap is marked. This will become the level of shortening required to allow the knee to fully extend and to flex to 90° (middle right). The femur is shortened at the second mark (bottom left). The shortened femur is fixed with a plate. The knee is able to flex to 90° with the patella located (bottom right)

Figure 4: Knee flexion contracture with external rotatory subluxation of tibia and dislocated patella after previous femoral lengthening (top). After posterior capsulotomy and relocation of patella, the femur is cut and the bone ends are allowed to overlap as the knee is fully extended. The overlap for extension is marked (middle left). The relocation of the patella tightens the contracted quadriceps. Flexion of the knee further shortens the femur with greater overlap of the bone ends. This greater overlap is marked. This will become the level of shortening required to allow the knee to fully extend and to flex to 90° (middle right). The femur is shortened at the second mark (bottom left). The shortened femur is fixed with a plate. The knee is able to flex to 90° with the patella located (bottom right)