Treatment of genu valgum by a novel percutaneous transverse metaphyseal osteotomy of the distal femur in children and adolescents.

Autor: Barakat AS; Orthopaedic Surgery Department, Cairo University, Cairo, Egypt., Arafa A; Orthopaedic Surgery Department, Cairo University, Cairo, Egypt., Mohamed MT; Orthopaedic Surgery Department, Cairo University, Cairo, Egypt., Zein AB; Orthopaedic Surgery Department, Cairo University, Cairo, Egypt., Afifi A; Orthopaedic Surgery Department, Cairo University, Cairo, Egypt. ahmedafifi@kasralainy.edu.eg., Wanas JSF; The National Institute of the Neuromotor System, Imbaba, Giza, Egypt., El Barbary H; Orthopaedic Surgery Department, Cairo University, Cairo, Egypt., Hanna A; Orthopaedic Surgery Department, Cairo University, Cairo, Egypt., Hegazy M; Orthopaedic Surgery Department, Cairo University, Cairo, Egypt., Khalifa AH; Klinik Für Unfallchirurgie, Medizinische Hochschule, Hannover, Germany.
Jazyk: angličtina
Zdroj: European journal of orthopaedic surgery & traumatology : orthopedie traumatologie [Eur J Orthop Surg Traumatol] 2022 Aug; Vol. 32 (6), pp. 1179-1186. Date of Electronic Publication: 2021 Aug 14.
DOI: 10.1007/s00590-021-03093-y
Abstrakt: Purpose: To evaluate the outcomes of a novel percutaneous medial supracondylar femoral osteotomy and above-knee cast technique in children and adolescents as a minimally invasive surgical intervention for treatment of genu valgum.
Methods: In this prospective study, 60 patients (70 knees) with a tibiofemoral angle more than 15° were treated with a novel medial percutaneous supracondylar femoral osteotomy and above-knee cast and followed up for an average of 29 months. The radiological outcome was measured with MAD, TFA, and mLDFA. The functional outcome was evaluated by a modified Böstman score.
Results: The preoperative mean MAD, TFA, and mLDFA were 2.9 cm, 16.3°, and 79.2° respectively. The Böstman score averaged preoperatively 23.1. There was a significant improvement of all radiological and clinical outcome measures (P < 0.001). Per Böstman score, 2 knees in one patient (3%) showed an unsatisfactory result, while 14 (20%) and 54 (77%) knees had a good or excellent result, respectively. Two patients (three limbs) needed early re-casting. Other complications were not encountered.
Conclusion: In experienced hands, percutaneous transverse metaphyseal femoral osteotomy and above-knee casting appear to be a safe, supracondylar cost-effective, and reliable minimally invasive acute correction technique in genu valgum in children and adolescents.
Level of Evidence: Level IV-therapeutic.
(© 2021. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)
Databáze: MEDLINE
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