Distal Femoral Osteotomy
In this article, we describe our most well-liked operative technique for a lateral opening wedge varus-producing distal femoral osteotomy to correct delicate to moderate valgus malalignment. Video 1 The video describes our most popular approach for lateral opening wedge distal femoral osteotomy. PearlsRadiolucent retractors enable fluoroscopic visualization whereas the osteotomy is performed.The surgeon should mark the saw 5-10 mm shorter than the size of the wire to avoid plunging and violating the lateral cortex. Two separate marks may be used to correspond to the lengths of the anterior and posterior wires, respectively.Gentle and/or sluggish closing of the osteotomy hole ought to be performed to keep away from fracture of the lateral cortex.
Through appropriate indication and patient selection, both kinds of valgisation osteotomies near the knee joint can provide improvements in scientific function, ache level and high quality of life. These joint-preserving interventions thus symbolize a valuable remedy choice in varus deformities. Varus deformities of the knee are regularly corrected by osteotomies, which should be carried out at the stage of origin. But in distinction to high tibial osteotomies , little information exists for distal femoral osteotomies . An Osteotomy is a managed surgical break or fracture of the bone to allow realignment of the limb.
Dfo (distal Femoral Osteotomy)
Diagnostic arthroscopy can be used to evaluate for related meniscoligamentous or cartilage injuries for concomitant procedures with the osteotomy. The denoted buildings symbolize the lateral femoral condyle , the lateral meniscus , and the lateral tibial plateau . The goal of surgical procedure is to re-create impartial alignment, such that the mechanical axis line passes via the middle of the knee.three The amount of correction is calculated primarily based on the angle fashioned between the mechanical axis of the femur and tibia . Practically, 5 degrees of malalignment is the brink to consider osteotomy.
- This article supplies an in depth, step-sensible technique that permits the reproducible creation of a medial closing-wedge DFO for the valgus knee using locking-plate fixation.
- Typically, a more lateral pores and skin incision is made to realize entry to the lateral femoral cortex.
- Closure is then completed in layers with the medial patellofemoral ligament repaired if partially transected.
- Commonly, genu valgum happens because of femoral malalignment and should be corrected with a DFO, whereas genu varum happens because of tibial malalignment and ought to be corrected with an HTO.
- The TomoFix medial distal femur anatomical plate was bent according to the person’s anatomy and positioned beneath the vastus medialis muscle for osteotomy fixation .
Bone fusion is achieved and %MA is forty eight.5% from the medial edge of the tibial plateau. Severe valgus deformity is famous with an FTA of a hundred and sixty degrees and a %MA of a hundred% from the medial fringe of the tibial plateau. Limitations of this study are the heterogeneous examine population and the low case quantity for femoral and tibial osteotomies. The expected number of cases within this cohort and the imply values and standard deviations in accuracy and clinical end result parameters in previous research have been too small for a potential energy evaluation. Additionally, long-term information about scientific function or survival charges is lacking. Several authors report an improvement of medical scores for as much as 5 years postoperatively after HTO.