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14-08-2021 | Supracondylar Femoral Osteotomy | Original Article

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

Authors: Ahmed Samir Barakat, Amr Arafa, Mohamed Tageldeen Mohamed, Abo Bakr Zein, Ahmed Afifi, Joseph Salah Farah Wanas, Hassan El Barbary, Atef Hanna, Mohamed Hegazy, Ahmed Hosny Khalifa

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 6/2022

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Abstract

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.
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Metadata
Title
Treatment of genu valgum by a novel percutaneous transverse metaphyseal osteotomy of the distal femur in children and adolescents
Authors
Ahmed Samir Barakat
Amr Arafa
Mohamed Tageldeen Mohamed
Abo Bakr Zein
Ahmed Afifi
Joseph Salah Farah Wanas
Hassan El Barbary
Atef Hanna
Mohamed Hegazy
Ahmed Hosny Khalifa
Publication date
14-08-2021
Publisher
Springer Paris
Published in
European Journal of Orthopaedic Surgery & Traumatology / Issue 6/2022
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-021-03093-y