Medial closed-wedge distal femoral osteotomy with local bone grafts for large collapsed steroid-induced osteonecrosis of the lateral femoral condyle: A case report

2021 ◽  
Author(s):  
Takuma Kaibara ◽  
Eiji Kondo ◽  
Masatake Matsuoka ◽  
Koji Iwasaki ◽  
Tomohiro Onodera ◽  
...  
Keyword(s):  
Case Report ◽  
Femoral Condyle ◽  
Bone Grafts ◽  
Femoral Osteotomy ◽  
Lateral Femoral Condyle ◽  
Distal Femoral Osteotomy ◽  
Local Bone ◽  
Closed Wedge

The Ideal Location of the Lateral Hinge in Medial Closing Wedge Osteotomy of the Distal Femur: Analysis of Soft Tissue Coverage and Bone Density

2019 ◽  
Vol 47 (12) ◽  
pp. 2945-2951
Author(s):  
Tae Woo Kim ◽  
Myung Chul Lee ◽  
Jae Ho Cho ◽  
Jong Seop Kim ◽  
Yong Seuk Lee
Keyword(s):  
Soft Tissue ◽  
Bone Density ◽  
Femoral Condyle ◽  
Femoral Osteotomy ◽  
Lateral Femoral Condyle ◽  
Soft Tissue Coverage ◽  
Distal Femoral Osteotomy ◽  
Closing Wedge ◽  
Hinge Position ◽  
Lateral Head

Background: Although an appropriate hinge position to prevent unstable lateral hinge fractures is well established in medial opening wedge high tibial osteotomy, the position during medial closing wedge distal femoral osteotomy has not been elucidated. Purpose/Hypothesis: The purpose was to evaluate the ideal hinge position that would prevent an unstable lateral hinge fracture during biplanar medial closing wedge distal femoral osteotomy based on soft tissue coverage and bone density around the hinge area. The hypothesis was that the ideal hinge position could be clarified by analyzing soft tissue coverage and bone density around the lateral hinge area. Study Design: Controlled laboratory study. Methods: In 20 cadaveric knees (mean age, 70.3 ± 19.2 years), the femoral attachment of the gastrocnemius lateral head was quantitatively analyzed as a soft tissue stabilizer using digital photography and fluoroscopy. Then, medial closing wedge distal femoral osteotomy was performed, locating the lateral hinge either inside (group 1) or outside (group 2) the femoral attachment of the gastrocnemius lateral head, and the incidence of unstable lateral hinge fractures was compared between the 2 groups. Cortical bone density around the lateral hinge was measured using Hounsfield units on 30 computed tomography scans and reconstructed as a 3-dimensional mapping model. The transitional zone with low bone density was regarded as the safe hinge position with an increased capacity for bone deformation. Results: The upper and lower margins of the femoral attachment of the gastrocnemius lateral head were 9.1 ± 0.9 mm above and 8.0 ± 1.4 mm below the upper border of the lateral femoral condyle, respectively, and the femoral attachment of the gastrocnemius lateral head was widest in the anteroposterior dimension 0.4 ± 1.7 mm above the upper border of the lateral femoral condyle. The incidence of unstable lateral hinge fractures during osteotomy was significantly decreased in group 1 compared with group 2 (group 1: 0/10; group 2: 5/10; P = .01). An isolated transitional zone with low bone density was observed in all 30 knees and located 1.3 ± 0.8 mm above the upper border of the lateral femoral condyle. Bone density of the transitional zone with low bone density was significantly lower than surrounding femoral cortices ( P < .001). Conclusion: Only the upper border of the lateral femoral condyle can be recommended as an ideal hinge position to prevent unstable lateral hinge fractures during biplanar medial closing wedge distal femoral osteotomy based on soft tissue coverage and bone density. Clinical Relevance: When the hinge is positioned at the upper border of the lateral femoral condyle during biplanar medial closing wedge distal femoral osteotomy, the risk of unstable hinge fractures can be minimized.

How the orientation of osteotomy in biplanar lateral closed-wedge distal femoral osteotomy influences the rotational alignment of the knee in all dimensional planes

The Knee ◽  
2021 ◽  
Vol 29 ◽  
pp. 167-173
Author(s):  
Hiroshi Nakayama ◽  
Ryo Kanto ◽  
Tomoya Iseki ◽  
Shintaro Onishi ◽  
Shunichiro Kambara ◽  
...  
Keyword(s):  
Femoral Osteotomy ◽  
Rotational Alignment ◽  
Distal Femoral Osteotomy ◽  
Closed Wedge

scholarly journals Medial Closed Wedge Distal Femoral Osteotomy Using a Novel Plate With an Optimal Compression System

2021 ◽  
Author(s):  
Ryuichi Nakamura ◽  
Takenori Akiyama ◽  
Ryohei Takeuchi ◽  
Hiroshi Nakayama ◽  
Eiji Kondo
Keyword(s):  
Femoral Osteotomy ◽  
Distal Femoral Osteotomy ◽  
Compression System ◽  
Closed Wedge

Distal femoral osteotomy for genu valgum deformity caused by malunited Hoffa fracture

2021 ◽  
Vol 14 (2) ◽  
pp. e238615
Author(s):  
Taiga Oda ◽  
Akira Maeyama ◽  
Tetsuro Ishimatsu ◽  
Takuaki Yamamoto
Keyword(s):  
Internal Fixation ◽  
Femoral Condyle ◽  
Weight Bearing ◽  
Young Patients ◽  
Femoral Osteotomy ◽  
Posterior Aspect ◽  
Distal Femoral Osteotomy ◽  
Non Union ◽  
Hoffa Fracture ◽  
Articular Fractures

Hoffa fractures are unstable intra-articular fractures of the femoral condyle that occur in the coronal plane.Insufficient anatomical reduction and internal fixation may lead to non-union or malunion. A 39-year-old man was involved in a traffic accident while riding a motorcycle and was diagnosed with left Hoffa fracture and avulsion fracture of the femoral attachment of the medial collateral ligament. Open reduction and internal fixation were performed 5 days after injury. The patient experienced intermittent knee pain, joint contracture and deformity, and attended our hospital for further treatment 18 months after surgery. CT revealed depression and malunion of the posterior aspect of the lateral femoral condyle, and weight-bearing X-ray showed valgus deformity due to malunion. Distal femoral osteotomy (DFO) was performed and good functional and radiographic results were obtained. This report suggests that DFO is a reasonable treatment for young patients suffering from malalignment due to malunited Hoffa fracture.

scholarly journals Distal Femoral Osteotomy for Epiphyseal Plate Injury in Congenital Sensory Neuropathy with Anhidrosis .A case Report.

1994 ◽  
Vol 43 (2) ◽  
pp. 534-537
Author(s):  
Yasuo Oda ◽  
Takayuki Satake ◽  
Takehiko Torisu ◽  
Masahiko Nakamura
Keyword(s):  
Case Report ◽  
Sensory Neuropathy ◽  
Femoral Osteotomy ◽  
Epiphyseal Plate ◽  
Distal Femoral Osteotomy
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