Description
Why do some patients struggle to fully straighten their knee during limb lengthening?
One of the most common complications during tibia and femur lengthening is Flexion Fixed Deformity (FFD)—a condition where the knee gradually loses its ability to fully straighten.
In this video, we explain why FFD develops, how it affects recovery, and what patients can do to prevent it.
What Is Flexion Fixed Deformity (FFD)?
FFD occurs when the knee remains in a partially bent position because the surrounding muscles and soft tissues become tight during the lengthening process.
If left untreated, it can affect:
🦵 Walking pattern
⚖️ Balance
🚶 Weight-bearing
💪 Long-term knee function
Why Does FFD Happen?
During limb lengthening:
🦴 Bones gradually become longer.
At the same time, muscles, tendons, and nerves must stretch and adapt.
Keeping the leg bent for prolonged periods can lead to:
❌ Muscle tightness
❌ Reduced knee extension
❌ Increased joint stiffness
❌ Nerve irritation and discomfort
How Can FFD Be Prevented?
The key is maintaining a balance between:
✅ Knee bending (flexion)
✅ Knee straightening (extension)
Daily rehabilitation should include:
💪 Stretching exercises
🦵 Range of motion training
🚶 Walking practice
🏥 Supervised physiotherapy
Early intervention is much easier than treating established stiffness.
Why Physiotherapy Is Critical
Physiotherapy helps:
✅ Maintain full knee range of motion
✅ Reduce muscle tightness
✅ Protect nerves and joints
✅ Improve walking mechanics
Consistent rehabilitation is one of the most effective ways to reduce the risk of Flexion Fixed Deformity.
Final Insight
FFD is one of the most preventable complications in limb lengthening surgery.
By following your rehabilitation program, maintaining knee mobility, and working closely with your physiotherapy team, you can significantly improve your recovery and long-term outcomes.
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