Comparative analysis of surgical treatment modalities for a popliteal pterygium: a meta-analysis.

Knee flexion contracture Meta-analysis Popliteal pterygium Popliteal webbing

Journal

Archives of orthopaedic and trauma surgery
ISSN: 1434-3916
Titre abrégé: Arch Orthop Trauma Surg
Pays: Germany
ID NLM: 9011043

Informations de publication

Date de publication:
13 Apr 2024
Historique:
received: 22 12 2023
accepted: 17 03 2024
medline: 13 4 2024
pubmed: 13 4 2024
entrez: 13 4 2024
Statut: aheadofprint

Résumé

Popliteal pterygium syndrome is a rare congenital disorder characterized by orofacial, cutaneous, musculoskeletal, and genital anomalies. The popliteal pterygium (PP) affects ambulation due to severe knee flexion contracture and equinovarus deformities. Surgical treatment aims to correct these deformities while preserving limb sensibility. However, due to its rarity, surgical guidelines are lacking. A meta-analysis according to PRISMA guidelines was conducted to summarize and compare surgical methods for PP. 183 paper were identified in PubMed and data from 32 articles were analyzed, including patient demographics, treatment modalities (Ilizarov fixator, femoral osteotomy, skin/soft tissue procedures, hamstring release, nerve surgery, and amputation), pre- and post-operative abilities to walk, knee joint parameters, complications, and recurrent contractions. Among 58 patients (87 limbs), Ilizarov fixator demonstrated improved knee and ankle mobility postoperatively, but showed a relatively high surgical session count and complication rates. Femoral osteotomy achieved successful knee posture correction with fewer sessions and no complications. Isolated skin/soft tissue procedures improved flexion contracture and mobility, though they required several procedures. Hamstring release achieved notable contracture reduction but also necessitated multiple interventions. Nerve surgery and amputation had limited data, warranting further investigation. The management of PP demands a comprehensive approach, considering individual patient characteristics and treatment outcomes. While different surgical modalities offer distinct benefits, a classification or guideline to treat this deformity is still lacking. Further research is essential to validate findings, refine treatment approaches, and enhance the quality of life for individuals with PP.

Identifiants

DOI: 10.1007/s00402-024-05292-8 PMID: 38613612
pubmed: 38613612
doi: 10.1007/s00402-024-05292-8
pii: 10.1007/s00402-024-05292-8
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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Auteurs

Martin Aman (M)

Department of Hand Surgery, Peripheral Nerve Surgery and Rehabilitation, Clinic of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Klinik Ludwigshafen, University of Heidelberg, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Heidelberg, Germany.

Maiwand Sidiq (M)

Department of Hand Surgery, Peripheral Nerve Surgery and Rehabilitation, Clinic of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Klinik Ludwigshafen, University of Heidelberg, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Heidelberg, Germany.
Department of Plastic and Reconstructive Surgery, Marienhospital Stuttgart, Teaching Hospital of the Eberhard Karls University, Böheimstraße 37, 72074, Tübingen, Germany.

Anna Pennekamp (A)

Department of Hand Surgery, Peripheral Nerve Surgery and Rehabilitation, Clinic of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Klinik Ludwigshafen, University of Heidelberg, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Heidelberg, Germany.
Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany.

Leila Harhaus (L)

Department of Hand Surgery, Peripheral Nerve Surgery and Rehabilitation, Clinic of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Klinik Ludwigshafen, University of Heidelberg, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Heidelberg, Germany.
Section Upper Extremity, University Hospital Heidelberg, Schlierbacher Landstr. 200a, 69118, Heidelberg, Germany.

Mirjam Thielen (M)

Department of Hand Surgery, Peripheral Nerve Surgery and Rehabilitation, Clinic of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Klinik Ludwigshafen, University of Heidelberg, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Heidelberg, Germany. mirjam.thielen@bgu-ludwigshafen.de.
ORCID: 0000-0003-0337-8570

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