Strategies in Trauma and Limb Reconstruction

Register      Login

VOLUME 10 , ISSUE 1 ( April, 2015 ) > List of Articles

Original Article

Femoral supracondylar focal dome osteotomy with plate fixation for acute correction of frontal plane knee deformity

Sherif Ahmed El Ghazaly, El-Hussein Mohamed El-Moatasem

Keywords : Knee valgus, Varus knee, Frontal knee deformity, Focal osteotomy, Femoral osteotomy, Dome osteotomy

Citation Information : El Ghazaly SA, El-Moatasem EM. Femoral supracondylar focal dome osteotomy with plate fixation for acute correction of frontal plane knee deformity. 2015; 10 (1):41-47.

DOI: 10.1007/s11751-015-0218-2

License: CC BY-NC-SA 4.0

Published Online: 30-04-2015

Copyright Statement:  Copyright © 2015; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Focal dome osteotomy (FDO) allows deformity correction without secondary translational deformity. The purpose of this study was to evaluate the degree of correction and knee functional outcome after correction of frontal knee deformity using femoral supracondylar FDO fixed with plate and screws. A prospective study included 12 consecutive cases of femoral frontal plane deformity that underwent correction using supracondylar focal osteotomy fixed by plate and screws. Average age was 27 years, while mean follow-up was 2.1 years. Functional assessment was done using the Hospital for Special Surgery (HSS) knee score. The HSS knee score improved from 85 to 96.8 points. Desired correction was achieved in all cases. Postoperative mechanical axis analysis on long film and scanogram showed no secondary deformity. The overall postoperative mechanical axis was at 3.2 mm medially (range 2–5 mm). Autogenous bone graft was not used in any case, and uneventful osteotomy union was achieved at a mean of 13.8 weeks. Minor complications were encountered in two cases. There were no implant failures or reoperations. Supracondylar FDO of the femur with plate fixation is a reproducible technique that can produce full correction of distal femoral frontal plane deformity, while avoiding creating a secondary deformity. Knee function was improved with good patient satisfaction.


PDF Share
  1. Hankemeier S, Paley D, Pape HC, Zeichen J, Gosling T, Krettek C (2004) Knee para-articular focal dome osteotomy. Orthopade 33(2):170-177
  2. Paley D (2002) Osteotomy concepts and frontal plane realignment. In: Herzenberg JE (ed) Principles of deformity correction, 1st edn. Springer, Berlin, p 112
  3. Paley D (2002) Hardware and osteotomy considerations. In: Herzenberg JE (ed) Principles of deformity correction, 1st edn. Springer, Berlin, p 300
  4. Sundaram NA, Hallett JP, Sullivan MF (1986) Dome osteotomy of the tibia for osteoarthritis of the knee. J Bone Joint Surg (Br) 68(5):782-786
  5. Watanabe K, Tsuchiya H, Sakurakichi K, Matsubara H, Tomita K (2008) Acute correction using focal dome osteotomy for deformity about knee joint. Arch Orthop Traum Surg 128(12):1373-1378
  6. Gugenheim JJ, Brinker MR (2003) Bone realignment with use of temporary external fixation for distal femoral valgus and varus deformities. J Bone Joint Surg 85-A(7):1229-1237
  7. Heervarden RJV, Wymenga AB, Freiling D, Staubli AE (2008) Indications-planning-surgical techniques using plate fixators. In: Lobenhoffer P, Heervarden RJV, Staubli AE, Jakob RP (eds) Osteotomies around the knee, 1st edn. Thieme Medical Publishers, New York, p 147
  8. Paley D, Tetsworth K (1992) Mechanical axis deviation of the lower limbs: preoperative planning of uniapical angular deformities of the tibia or femur. Clin Orthop 280:48-64
  9. Paley D, Tetsworth K (1992) Mechanical axis deviation of the lower limbs: preoperative planning of multiapical frontal plane and angular bowing deformities of the femur and tibia. Clin Orthop 280:65-71
  10. Heervarden RJV, Wymenga AB, Freiling D, Staubli AE (2008) Indications- Planning- Surgical Techniques using plate fixators In: Lobenhoffer P, Heervarden RJV, Staubli AE, Jakob RP (eds) Osteotomies around the knee, 1st edn. Thieme Medical Publishers, New York, p 153
  11. Strecker W (2006) Corrective osteotomy of the distal femur by retrograde nailing. Euro J Trauma 32(1):83-95
  12. Wang JW, Hsu CC (2008) Distal femoral varus osteotomy for osteoarthritis of the knee. Surgical technique. J Bone Joint Surg Am 88(Suppl 1):100-108
  13. Seah MKT, Shafi R, Fragomen AT, Rozbruch SR (2011) Distal femoral osteotomy: is internal fixation better than external? Clin Orthop Relat Res 469(7):2003-2011
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.