We assessed the results of the treatment of severe iatrogenic infantile quadriceps retraction in a pediatric surgery department, which still admits such cases. We used two different surgical techniques of quadricepsplasty: one based on the Judet technique and the other based on the Payr and Thompson techniques. We selected the technique to perform according to the initial rate of limitation of the range of movement of the knee. We followed 76 patients operated on with one of the two techniques for at least 3 years. There were 94 cases operated on with a modified Judet technique and 34 according to the Payr-Thompson technique. After 3 years, maximal knee flexion improved from an average of -3 to 81 degree in the first group and from 37 to 115 degree in the second group. The most frequent complications were skin necrosis after the Judet quadricepsplasty and active extension lag after the Payr-Thompson procedure.

The complication rate is consistent with that reported in the literature. Correct determination of the levels to be instrumented, preoperative improvement of nutritional status, and better evaluation of the preoperative and postoperative respiratory function are important factors in minimizing the potential complications of a technique that is used in weak patients with complex deformities.