Management of Angular Deformities around Knee in Children by Dome Osteotomy
Journal Title: Journal of Bone and Joint Diseases - Year 2018, Vol 0, Issue 0
Abstract
Background: Coronal plane deformity around knee persisting beyond 8 years of age is a matter of concern for a treating surgeon as well as parents. e corrective dome osteotomy surgery provides beer adjustability of osteotomized fragments, large bone-to-bone contact, and stability. e present study assesses the surgical correction of angular deformities around knee in children by corrective dome osteotomy, evaluates cosmetic, functional, and anatomical outcome based on clinical and radiological follow-up, and assesses the range of motion of knee after surgical management. Materials and Methods: A prospective clinical study was performed on 16 patients presenting with coronal plane deformity of knee, aged <16 years, and satisfying our inclusion criteria. After thorough clinical and radiological assessment, dome osteotomy was done and stabilized by cross K-wires (2.5 mm). Post-operative measurements of tibiofemoral angle (TFA), intermalleolar and intercondylar distance, scanogram for the calculation of radiological TFA, mechanical axis deviation, mechanical medial proximal tibial angle (m MPTA), and mechanical lateral distal femoral angle (m LDFA) were done and compared with pre-operative values. Patients were followed for any complication, time of osteotomy union, and range of motion of knee after operation. Results: Out of 16 patients operated, 15 (93.75%) had valgus deformity and only 1 (6.25%) had varus deformity, and 11 were male and 5 were female; the mean time of osteotomy union was 11.88 weeks (range 8–16 weeks) and no patient had non-union. Mean valgus deformity of 28.93° improved to 8° and mean varus deformity of 10° improved to 0° post-operatively. Mean duration of cast was 7.8 weeks (range 6–10 weeks). Conclusion: Dome osteotomy is a simple, safe, and easy procedure for correcting coronal plane deformities around knee in children before skeletal maturity. It does not cause limb length discrepancy and stable even by minimal internal fixation such as cross K-wire and plaster.
Authors and Affiliations
Latif Zafar Jilani, Ziaul Hoda Shaan, Muneer Ahmed, Sohail Ahmad, Mohd. Faizan, Mazhar Abbas, Naiyer Asif
Keywords
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