Outcome of Dome Osteotomy With Plate Osteosynthesis for Genu Valgum in Late Adolescents and Young Adults

Bansal, Kuldeep; Mishra, Puneet; Chadha, Manish; Shahi, Pratyush; Anshuman, Rahul; Aggarwal, Aditya

doi:10.7759/cureus.7894

Cited by 2 publications

(2 citation statements)

References 18 publications

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“…Bansal et al reported hypertrophic scar formation, superficial wound infection and loss of correction in their study of 21 patients for which dome osteotomy was done and fixed with low-profile proximal humerus locking plate. 25 Watanabe et al have done a similar osteotomy and reported three cases of pin tract infections, three cases of delayed unions, one case of joint contracture, and one case of transient peroneal nerve palsy, but function recovered completely without treatment. Limb lengthening was performed in five patients and they concluded that acute correction with focal dome osteotomy is very useful for cases of alignment correction, but is not indicated for cases of alignment correction with lengthening, due to a high risk of complications related to poor callus formation.…”

Section: Discussionmentioning

confidence: 99%

Wedge-less oblique supracondylar femoral osteotomy and casting for genu valgum in older children and young adults

Rustagi¹,

Hussain

2022

Journal of Clinical Orthopaedics and Trauma

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Background: Genu valgum is one of the commonest deformities seen by the orthopaedicians. The most common cause is idiopathic but genu valgum secondary to nutritional deficiency is also fairly common in developing and third world countries. Supracondylar osteotomy and internal fixation with plate and screws, is the treatment of choice in older children and young adults, which is costly, requires a wide exposure, a second surgery for implant removal and risk of infection is more. This study was undertaken to measure the outcome of simple oblique percutaneous wedge-less metaphyseal supracondylar osteotomy of the distal femur and casting in older children and adolescents with Genu Valgum in a small centre catering mostly to patients from middle and low income households. Patients and methods: Patients aged between 12 and 22 years with genu valgum deformity with a tibiofemoral angle 15 , and an intermalleolar distance of more than 7 cm in unilateral and more than 10 cm in bilateral cases, who are not amenable to be treated with guided growth techniques, were included. Patients having knee instability, restriction of knee range of motion, genu recurvatum, tibial deformity component, open physis, were excluded from the study. The correction was undertaken by a simple supracondylar wedge-less metaphyseal short oblique osteotomy of the distal femur followed by immobilization with a long leg plaster of Paris cast. Functional outcome was assessed using B€ ostman et al. score. Results: 46 limbs in 29 patients with a mean age of 14.5 years were operated. The mean follow-up of patients was 6 months. The preoperative radiological tibiofemoral angle (TFA) had a mean value of 19.89 which improved to a mean of 5.31 postoperatively. Intermalleolar distance (IMD) improved from a mean of 13.81 cm to 3.15 cm post-correction. Mean Lateral distal femoral angle (LDFA) improved from 77.11 to 87.20 . Knee score was excellent in all patients at 3 months and 6 months post intervention. There were no serious complications except superficial plaster sores in 4 patients, which healed uneventfully and temporary restriction of knee range of motion in 5 patients. All patients achieved a full range of knee motion after physical therapy. Conclusion: Supracondylar wedge-less short oblique metaphyseal distal femoral osteotomy and immobilization with plaster of Paris cast is a simple, cheap, safe & viable option for the correction of genu valgum deformity originating from distal femur, with minimal complications in older children and adolescents with limited growth potential, especially in low income countries and small centres.

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Section: Discussionmentioning

confidence: 99%

Wedge-less oblique supracondylar femoral osteotomy and casting for genu valgum in older children and young adults

Rustagi¹,

Hussain

2022

Journal of Clinical Orthopaedics and Trauma

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“…In this setting, biplanar correction may be attempted with anterolateral OW-HTO [8][9][10] . Dome osteotomy with mediolateral and anteroposterior arching may also be considered, but is more often used to address one dominant deformity with a small amount of secondary correction [11][12][13] . The valgus knee without recurvatum is commonly treated with lateral opening wedge distal femoral osteotomy (LOW-DFO), a technique that demonstrates good outcomes [14][15][16] .…”

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confidence: 99%

Single-Stage Correction of Genu Valgum Recurvatum by Distal Femoral and High Tibial Opening Wedge Osteotomies

Setliff

Engler

Zsidai

et al. 2023

JBJS Case Connector

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Case: A 32-year-old woman with genu valgum recurvatum presented to clinic complaining of long-standing anterior knee pain. Radiographs demonstrated a 13°anterior tibial slope and 15°valgus malalignment. She underwent a single-stage 2-level osteotomy at the distal femur and proximal tibia to simultaneously correct genu valgum and recurvatum. This procedure achieved precise correction in both planes. At 1 year, the patient was pain-free and ambulated without restriction. Conclusion:This procedure should be considered among the available surgical options when treating genu valgum recurvatum because it produced excellent results for the studied patient. Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/C130).

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Outcome of Dome Osteotomy With Plate Osteosynthesis for Genu Valgum in Late Adolescents and Young Adults

Abstract: Bansal et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Cited by 2 publications

References 18 publications

Wedge-less oblique supracondylar femoral osteotomy and casting for genu valgum in older children and young adults

Wedge-less oblique supracondylar femoral osteotomy and casting for genu valgum in older children and young adults

Single-Stage Correction of Genu Valgum Recurvatum by Distal Femoral and High Tibial Opening Wedge Osteotomies

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