One-stage Surgical Treatment of Simultaneous Osteotomy and Asymmetric Lengthening on Short Femur with Severe Deformity of Genu Valgus

Xu, Huifa; Xu, Chao; Sha, Jingquan; Yan, Ya‐Bo; Li, Chao; Liu, Zhichen; Huang, Luyu; Lei, Wei

doi:10.1038/s41598-019-45157-4

Cited by 2 publications

(2 citation statements)

References 27 publications

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“…Though this results in a longer operation, the advantages of a combined procedure offset the increased surgery time. Such advantages include avoiding a 2nd procedure with general anesthesia and subsequent recovery time and postoperative pain, reducing cost, and decreasing hospitalization [15]. As a result, the simultaneous correction of multiple femoral deformities is expected to be [17].…”

Section: Discussionmentioning

confidence: 99%

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Combined antegrade femur lengthening and distal deformity correction: a case series

Jardaly

Gilbert

2021

J Orthop Surg Res

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Background Leg length discrepancy is often associated with distal femur angular deformities such as valgus or flexion. This study aims to report a new technique for simultaneous limb lengthening and acute distal femoral angular correction. Methods A retrospective chart review of patients undergoing a single procedure was conducted. Patients included had a single operation where they underwent distal femur osteotomy stabilized with a plate followed by antegrade nailing with a magnetically controlled intramedullary lengthening nail (PRECICE, Ellipse Technologies, Inc., Irvine, CA, USA) using a trochanteric entry. Results Seven femurs from 7 patients were included. The average age at operation was 13.6 years, and the leg length difference was 51 mm (range 30–105 mm). Associated deformities were valgus (4), knee flexion contracture (2), and both valgus and flexion contracture (1). Lengthening achieved was 43 mm (P = 0.0036), with a consolidation index of 27 days/cm and reliability of 0.87 (6/7). The 5 patients with angulation had an improvement of valgus from 12 to 4° (P = 0.006) and of the mechanical axis deviation from 34 to 3 mm (P = 0.0001). The range of motion also improved in the 3 patients with contractures. Preoperative gait disturbance, hip and knee pain, and functional scoliosis resolved after the limb deformities were corrected. Conclusion Combining a magnetic internal lengthening nail with a second distal osteotomy stabilized with a plate can successfully correct limb length and distal femur deformity acutely without altering the expected result of each procedure.

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Section: Discussionmentioning

confidence: 99%

“…Few reports exist on concomitant procedures to address combined deformities. They demonstrate adequate correction of angular deformities and LLD using one operation, but an external fixator is typically used [14][15][16]. Most commonly, retrograde nailing with blocking screws is used for distal femur deformities [14,17].…”

Section: Introductionmentioning

confidence: 99%

Combined antegrade femur lengthening and distal deformity correction: a case series

Jardaly

Gilbert

2021

J Orthop Surg Res

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Femoral malalignment deformity acute correction and gradual limb-lengthening by bifocal osteosynthesis with a monorail external fixator

Zhang,

Yu,

Wang

et al. 2024

Traumatology and Orthopedics of Russia

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Background. Patients with limb-length discrepancies often present with concomitant distal femoral varus or valgus deformities. With the development of distraction osteogenesis, both deformity correction and limb-lengthening can be performed simultaneously. This novel procedure is being increasingly preferred not only by experts due to the technical advance it implies, but also by patients. The aim of this study was to identify the clinical efficacy of distal femoral malalignment deformity correction and gradual limb-lengthening by bifocal osteotomies. Methods. We analyzed 32 femurs from 30 patients (mean age — 23.8 years) who had undergone bifocal osteotomies followed by the use of the monorail external fixator to correct the distal femoral malalignment deformity acutely and limb-length discrepancy gradually from June 2012 to May 2020. Pre-operative clinical and radiographic data were also obtained. During the follow-up period, deformity correction and bone healing were assessed, complications were identified, and functional outcomes were evaluated. Results. The mean follow-up period was 57.2 months for all the patients. The mean mechanical axis deviation improved from 66.4 mm pre-operatively to 7.5 mm. In patients with varus deformity, the mean mechanical lateral distal femoral angle (mLDFA) decreased from 121.2° pre-operatively to 90.2° after surgery; whereas in patients with valgus deformity, the mean mLDFA improved from 59.2 to 87.1°. The magnitude of lengthening achieved averaged 6.3 cm, and the mean bone healing index was 34.8 days/cm. The final scores defined by the Association for the Study and Application of the Methods of Ilizarov (ASAMI)-Paley were excellent in 93.3% of patients. Conclusions. Acute correction of femoral deformities and gradual lengthening with a monorail external fixator following bifocal osteotomies can be used to treat femoral shortening and distal malalignment deformity. Functional and cosmetic improvements are expected after surgery and post-operative rehabilitation.

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One-stage Surgical Treatment of Simultaneous Osteotomy and Asymmetric Lengthening on Short Femur with Severe Deformity of Genu Valgus

Cited by 2 publications

References 27 publications

Combined antegrade femur lengthening and distal deformity correction: a case series

Combined antegrade femur lengthening and distal deformity correction: a case series

Femoral malalignment deformity acute correction and gradual limb-lengthening by bifocal osteosynthesis with a monorail external fixator

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