Orellana-Reta C, Valdez-Jiménez LA

Language: Spanish
References: 10
Page: 141-144
PDF size: 194.56 Kb.

ABSTRACT

Objective: The aim of this study was to evaluate the functional and radiographic results of adolescent patients with angular deformities of the pelvic limbs treated with an open wedge osteotomy system. Material and methods: Observational, prospective, analytical and cross-sectional study of patients with angular deformity of the pelvic limbs treated with an open wedge osteotomy. We made a radiographic evaluation of the femorotibial angle, MAD angle, lower limb discrepancy, and pre- and postoperative degrees of the rotational center of deformity (CORA), as well as a telephone survey of the postoperative functional evaluation IKDC 2000. Results: It was a sample of 28 patients, 21 female and seven male, with a mean age of 15.3 years. Their diagnoses: idiopathic genu valgo, 10 cases; Blount disease, four; benign tumors (enchondromatosis and osteochondromatosis), three; hypophosphatemic rickets; three, among others, such as sequelae of septic arthritis of the knee, femoral hypoplasia, and fracture sequels. It was a total of 29 osteotomies, 17 of the tibia and 12 of the femur; 17 osteotomies presented deviation to lateral of the mechanical axis, and 11, medial deviation, with a mean femorotibial angle of 17 and 7.35 (p ‹ 0.03), respectively. The mean initial discrepancy had an improvement of 0.5 cm. Postoperative IKDC in the subjective evaluation had an average of 95.3 points. Conclusions: The fixation of osteotomies with open wedge plates is an option with good clinical and radiographic results.

REFERENCES

1. Paley D, Herzenberg J: Principles of deformity correction. 3rd ed. Baltimore: Springer; 2005: 821.

2. Sabzevari S, Ebrahimpour A, Roudi MK, Kachooei AR: High tibial osteotomy: a systematic review and current concept. Arch Bone Jt Surg. 2016; 4(3): 204-12.

3. Masrouha KZ, Sraj S, Lakkis S, Saghieh S: High tibial osteotomy in young adults with constitutional tibia vara. Knee Surg Sports Traumatol Arthrosc. 2011; 19(1): 89-93.

4. Puddu G, Cipolla M, Cerullo G, Franco V, Giannì E: Which osteotomy for a valgus knee? Int Orthop. 2010; 34(2): 239-47.

5. Ekeland A, Nerhus TK, Dimmen S, Heir S: Good functional results of distal femoral opening-wedge osteotomy of knees with lateral osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2016; 24(5): 1702-9.

6. Khanfour AA: A modified Puddu technique for the treatment of adolescent mild to moderate tibia vara. J Pediatr Orthop B. 2016; 25(1): 37-42.

7. De Mello Junior WA, Arruda LR, Coluccini AM, da Silva-Nunes RP, Pedro Mdo A, de Souza MR, et al: Complications following medial opening wedge osteotomy of the knee : retrospective study. Rev Bras Ortop. 2011; 46(1): 64-8.

8. Woodacre T, Ricketts M, Evans JT, Pavlou G, Schranz P, Hockings M, et al: Complications associated with opening wedge high tibial osteotomy —A review of the literature and of 15 years of experience. Knee. 2016; 23(2): 276-82.

9. Zorzi AR, da Silva HG, Muszkat C, Marques LC, Cliquet A Jr, de Miranda JB: Opening-wedge high tibial osteotomy with and without bone graft. Artif Organs. 2011; 35(3): 301-7.

10. Kim KJ, Song EK, Seon JK, Seol JH: Biomechanical study of the fixation plates for opening wedge high tibial osteotomy. Knee Surg Relat Res. 2015; 27(3): 181-6.