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Corrective osteotomy of the distal femur with fixator assistance: A novel technique of minimally invasive osteosynthesis.
- Source :
-
Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association [J Orthop Sci] 2017 May; Vol. 22 (3), pp. 474-480. Date of Electronic Publication: 2017 Jan 24. - Publication Year :
- 2017
-
Abstract
- Purpose: Varus or valgus deformity of the distal femur may progress into knee osteoarthritis. To delay or prevent this, various types of corrective osteotomy techniques have been used to shift the mechanical axis from the diseased compartment to the healthy one. We introduced a new, minimally invasive osteotomy of the distal femur with the assistance of temporary external fixation.<br />Methods: We retrospectively studied 25 legs that underwent open-wedge osteotomy of the distal femur, involving insertion of a Schanz pin at the medial femoral condyle and another pin at the distal diaphysis of the femur. At the meta-diaphyseal junction, osteotomy was performed. After achieving angular correction, two pins were locked for temporary external fixation and a locking plate was fixed at the lateral side of the femur submuscularly. Radiological and functional outcomes were evaluated, including mechanical lateral distal femoral angle (m-LDFA), mechanical axis deviation, tibiofemoral angle, osseous union, and knee joint motion.<br />Results: The minimum follow-up was 12 months (mean, 39 months; range, 12-88 months). Bone healing occurred in all legs, with an average of 16.6 weeks. The m-LDFA was corrected from 77.7° (18 valgus) and 104.6° (7 varus) to 88.1° after surgery, with an average correction of 12.9°. At the final follow-up, the mechanical axis deviation averaged 7.6 mm and the tibia-femoral angle averaged 5.6°. Most of legs (88%) achieved acceptable m-LDFA (87° ± 3°).<br />Conclusions: A new, minimally invasive osteotomy of the distal femur offers excellent bone healing with few complications, attributable to preserved blood supply.<br /> (Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.)
- Subjects :
- Adolescent
Adult
Aged
External Fixators adverse effects
Female
Femur diagnostic imaging
Follow-Up Studies
Humans
Internal Fixators adverse effects
Joint Deformities, Acquired diagnosis
Joint Deformities, Acquired physiopathology
Knee Joint diagnostic imaging
Knee Joint physiopathology
Male
Middle Aged
Osteoarthritis, Knee diagnosis
Osteoarthritis, Knee prevention & control
Postoperative Complications
Radiography
Range of Motion, Articular
Retrospective Studies
Time Factors
Treatment Outcome
Young Adult
Femur surgery
Joint Deformities, Acquired surgery
Knee Joint surgery
Minimally Invasive Surgical Procedures adverse effects
Orthopedic Fixation Devices adverse effects
Osteoarthritis, Knee etiology
Osteotomy methods
Subjects
Details
- Language :
- English
- ISSN :
- 1436-2023
- Volume :
- 22
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
- Publication Type :
- Academic Journal
- Accession number :
- 28129945
- Full Text :
- https://doi.org/10.1016/j.jos.2016.12.020