We reviewed retrospectively 94 patients who had undergone soft-tissue release to correct flexion contracture of the knee to determine the incidence of postoperative hypertension. The cause of contracture in most patients was cerebral palsy (45) or old poliomyelitis (39). Twenty patients developed persistent hypertension. Two of them were symptomatic, one developing hypertensive encephalopathy. Patients who had had poliomyelitis were at a higher risk than those with cerebral palsy; the risk increased with bilateral procedures. The amount of correction achieved had no influence on the incidence of hypertension.

After severe poliomyelitis, which is still relatively common in some developing countries, lateral rotation deformity of the tibia may occur. We have reviewed 51 patients treated by O'Donoghue's rotation osteotomy of the tibia. An average lateral rotation deformity of 57 degrees was fully corrected in all the patients, and in 38 of them the graft obtained during the osteotomy was used for a simultaneous Grice-Green subtalar arthrodesis in one or both feet. All the osteotomies united in an average of 11 weeks, some with relatively minor and unintentional posterior angulation. There was no posterior angulation when the length of the step cut osteotomy was 4.5 cm or more. O'Donoghue's osteotomy is a simple and safe operation, being particularly advantageous if a Grice-Green procedure is also required.