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Results of Wedgeless Distal Femoral Osteotomy for the Treatment of Genu Valgus Deformity
Sidhu, Gur Aziz Mubarak, Islam Alwadiya, Ahmed Mohamed, Nagy Ashwood, Neil
Sidhu, Gur Aziz
Mubarak, Islam
Alwadiya, Ahmed
Mohamed, Nagy
Abstract
Abstract Introduction: Coronal plane knee deformities are common disorders affecting adolescents. Valgus deformities (tibiofemoral angle (TFA) > 12-15 degrees and intermalleolar distance (IMD) > 10 cm) often require corrective osteotomy and a wedgeless "V" distal femoral osteotomy is a good treatment option for such deformities. Materials and methods: Thirty adolescent patients (13-17 years) with valgus deformities were included. Patients with severe collateral ligament instability, subluxation, and sagittal plane deformity > 15 degrees or genu valgum due to tibial deformity were excluded. Preoperative clinical (Bostman's knee score, IMD, and knee-flexion test) and radiological evaluations were done. The surgery (wedgeless distal femoral V osteotomy) was performed and stabilized with two Kirschner wires (K-wires). Postoperative clinical and radiological parameters were recorded including complications. Results: The preoperative TFA was 20.23 ± 3.63 degrees, which reduced to 5.5 ± 0.73 at six months postoperatively. The preoperative IMD was 12.45 ± 2.2 cm, which reduced to 1.63 ± 0.32 cm at six months. The mean mechanical axis deviation (MAD) and lateral distal femoral angle (LDFA) were recorded as 2.8 ± 0.39 and 87.7 ± 0.83, respectively, and the differences were statistically significant from preoperative values. The Bostman score was 26.2 ± 1.79 at three months and 29.47 ± 0.9 at six months. The complications included infection in two patients, a hypertrophic scar in one patient, and common peroneal neuropraxia in one patient. Conclusion: Wedgeless distal femoral osteotomy with K-wire fixation is a viable option for correction of genu valgus deformity with potential advantages of minimal blood loss, no leg length discrepancy, non-rigid fixation, and early union as compared to other treatment options.
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Citation
Cureus 14(11): e31500. DOI 10.7759/cureus.31500