Angular deformities of lower limb in children: Correction for whom, when and how?

Maffucci syndrome is a rare congenital, non-hereditary condition characterised by presence of multiple enchondromas and haemangiomas. Enchondromatous lesions affecting epiphysial growth plates can lead to angular deformities and leg-length discrepancy in the lower limb. We describe a 12-year-old girl with monomelic Maffucci syndrome affecting her left lower limb. She presented with progressive genu valgus deformity of her left knee. This caused her to limp during her gait and was a cosmetic dissatisfaction. The deformity affected her quality of life. She underwent a supracondylar distal femoral corrective osteotomy with a successful clinical outcome and restoration of her gait and cosmetic deformity.

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Angular Deformities in Lower Limb

Textbook of Orthopedics and Trauma (4 Volumes) ◽

10.5005/jp/books/12869_341 ◽

2016 ◽

pp. 3221-3221

Author(s):

GS Kulkarni ◽

RM Kulkarni ◽

Rajiv Negandhi

Keyword(s):

Lower Limb ◽

Angular Deformities

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Angular Deformities of the Lower Limb in Children

Asian Journal of Sports Medicine ◽

10.5812/asjsm.34871 ◽

2010 ◽

Vol 1 (1) ◽

Cited By ~ 24

Author(s):

Ramin Espandar ◽

Seyed Mohammad-Javad Mortazavi ◽

Taghi Baghdadi

Keyword(s):

Lower Limb ◽

Angular Deformities

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Two case reports of lower limb posttraumatic angular deformities correction by dynamic hinged external fixation

Acta chirurgica iugoslavica ◽

10.2298/aci1501069m ◽

2015 ◽

Vol 62 (1) ◽

pp. 69-74

Author(s):

Milan Mitkovic ◽

Sasa Milenkovic ◽

Ivan Micic ◽

Igor Kostic ◽

Predrag Stojiljkovic ◽

...

Keyword(s):

Hospital Stay ◽

External Fixation ◽

External Fixator ◽

Lower Limb ◽

Deformity Correction ◽

Operation Time ◽

Angular Deformity ◽

Surgical Trauma ◽

Hinged External Fixation ◽

Angular Deformities

The aim of this study was to present two patients with lower limb posttraumatic angular deformity treated by dynamic hinged external fixation. CD-V mode Mitkovic type external fixator had been used in both cases for correction of these deformities. The method is based on hemicallotasis - bone callus distraction after a partial transversal bone cut (hemocorticotomy). The first patient had varus-recurvatum posttraumatic deformity of the ankle joint. Operation time was 65 min and hospital stay was 9 days. Superficial pin-track infection was resolved by the pin removal and by daily wound toilette. The second patient had varus-antecurvatum malunion deformity of the femoral diaphysis. Operation time was 50 min and hospital stay was 6 days. Mild knee contracture had been successfully treated by physical therapy. Angular deformity correction had been performed by distraction (for the first patient) and compression (for the second patient) in the fixator frame. Hemicallotasis of femur or tibia using CD-V mode Mitkovic type external fixator is a good alternative in the treatment of posttraumatic lower limb angular deformities, providing minimal surgical trauma and maximal use of the bone osteogenetic capacity. Gradual compression or distraction in the fixator frame allows to perform accurate angular correction in both coronal and sagital plane in one act.

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Chapter-374 Angular Deformities in Lower Limb in Children

Textbook of Orthopaedics &amp Trauma Vol 1 ◽

10.5005/jp/books/10938_374 ◽

2008 ◽

pp. 3650-3657 ◽

Cited By ~ 1

Author(s):

Kulkarni GS

Keyword(s):

Lower Limb ◽

Angular Deformities

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Proximal Tibial Epiphysis Fracture in a 13-Year-Old Male Athlete

Case Reports in Orthopedics ◽

10.1155/2017/4823589 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Ioannis M. Stavrakakis ◽

Pavlos E. Katsoulis ◽

Maria S. Katsafarou

Keyword(s):

Lower Limb ◽

Growth Arrest ◽

Type Ii ◽

Cast Immobilization ◽

Male Athlete ◽

Below The Knee ◽

Popliteal Vessels ◽

Salter Harris ◽

Epiphyseal Injuries ◽

Angular Deformities

Fractures of the proximal epiphysis of the tibia are rare, representing 0.5 to 3.0% of all epiphyseal injuries. These injuries can damage the popliteal vessels and their bifurcation, affecting the blood supply of the lower limb, as well as the nerves below the knee. Epiphyseal growth arrest is also a potential complication, leading to various angular deformities. We present a case of a 13-year-old male athlete with a posteriorly displaced Salter-Harris type II fracture of the proximal epiphysis of the left tibia who was treated conservatively with closed reduction and cast immobilization.

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Our Experience with Correction of Angular Deformities of Knee by Flexible Figure of 8-plate Hemiepiphysiodesis

Indian Journal of Physical Medicine and Rehabilitation ◽

10.5005/ijopmr-23-2-68 ◽

2012 ◽

Vol 23 (2) ◽

pp. 68-73 ◽

Cited By ~ 1

Author(s):

PK Sahoo ◽

SK Das ◽

S Pradhan ◽

RN Mohanty

Keyword(s):

Lower Limb ◽

Effective Means ◽

Growth Arrest ◽

Angular Deformity ◽

Joint Degeneration ◽

Femorotibial Angle ◽

Gradual Correction ◽

Intermalleolar Distance ◽

Cosmetic Problem ◽

Angular Deformities

Abstract Background Genu valgum and genu varum deformity in the lower limb in children results in cosmetic problem, gait disturbance, pain and early joint degeneration. Most of them are physiological and improve to the normal adult femorotibial angle before the age of eight years. Persistent deformities are corrected by osteotomy and internal fixation or gradual correction by external fixation. Osteotomy has got its complications. Gradual correction also can be achieved by stapling, percutaneous drill technique and transphysial screw. Stapling has drawbacks related to implant failure including migration and breakage of implants. Drilling and screwing carries risk of permanent growth arrest. The timing of epiphysiodesis has to be perfect otherwise there may be under correction or overcorrection. 8-plate temporary hemi-epiphysiodesis is a new concept and producing good results with less complication. The objective of this study is to reduplicate the results of 8- plate hemiephiphysiodesis on angular deformities of knee joint. Methods We attempted gradual correction through 8-plate in 31 patients with 54 angular deformities around knee. Cases were followed for 38months (range, 24 to 52months) after removal of implants. Measurements were compared pre and postoperatively. Results There was statistically significant improvement in all the outcome measures measured. There was gross reduction of intermalleolar distance and reduction in angular deformity. Conclusions 8-plate hemiepiphysiodesis is an effective means for correcting angular deformity around the knee in skeletally immatured patients.

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