Use of a modified Quengel hinge to prevent posterior displacement of the tibia during treatment of PCL injury.

During treatment of posterior cruciate ligament (PCL) injuries, posterior displacement of the tibia may occur inside the cast due to the effect of gravity on the lower leg. To prevent this problem the authors attempted to apply the original Quengel cast, first described by Mommsen in 1922 and perfected by Jordan, to correct the flexion contracture of the knee in hemophiliacs. However, the authors found that the cast was not effective in preventing the posterior displacement of the tibia during management of PCL injuries. They modified the design of the original Quengel hinge to obtain a more effective anterior traction on the tibia parallel to the knee joint line. Of the 32 patients who used the modified Quengel brace, 15 who could be followed had less than a 3 mm difference between the injured and uninjured knee 3 months postoperatively.