Incomplete supracondylar femoral osteotomy and locking compression plate ifxation for genu valgum

HUANG Ye; JI Song-jie; DU Hui; SHAO Hong-yi

doi:10.3969/j.issn.2095-252X.2014.07.011

Abstract：Objective To evaluate the safety and efifcacy of incomplete supracondylar medial closing wedge osteotomy in the distal femur and locking compression plate ( LCP ) ifxation for genu valgum in a retrospective study. Methods From August 2011 to February 2013, 26 patients with genu valgum ( 37 knees ) underwent incomplete supracondylar closing wedge osteotomy and Tomoifx plate ifxation in the medial distal femur, whose mean age was 25.6 years old ( range: 18-37 years ). Lateral compartment osteoarthritis of the knee was classiifed as Ahlb?ck I stage. Results The mean follow-up duration was 23.6 months ( range: 13-31 months ). The preoperative and postoperative femoro-tibial angles were 160.2° ( 152-167 ) ° and 175.6° ( 171-178 ) ° respectively, with an average improvement of 14.4° ( 6-22 ) °. The preoperative and postoperative lateral distal femoral angles were 68.4° ( 60-74 ) ° and 82.3° ( 77-84 ) ° respectively, with an average improvement of 13.9° ( 7-21 ) °. The differences between the preoperative and postoperative angles were statistically signiifcant (P<0.05 ). The Hospital for Special Surgery ( HSS ) knee score was improved from 91.7 points ( range: 77-98 points ) preoperatively to 97.8 points ( range: 84-100 points ) postoperatively, with no statistically signiifcant differences (P>0.05 ). Delayed bone union was found in 2 of the 37 knees, which was related to the breakage and displacement of bone hinges. Reoperation was performed on 1 patient due to postoperative hematomas. Two patients were unsatisfied with the appearance of the lower limbs because of the alignment overcorrection. No non-union or infection was noticed.Conclusions The technique of incomplete supracondylar medial closing wedge osteotomy in the distal femur and LCP ifxation is safe and reliable, which can effectively correct genu valgum. The preservation of lateral bone and soft tissue hinges is the key of early bone healing.