Post traumatic genu valgum with valgus deformity of left lower femur and upper tibia valgus and procurvatum deformity with 10cm lld and puckering of skin around knee with bad scar

Post-traumatic femoral valgus and upper tibia valgus and procurvatum deformity with 10cm LLD were corrected with Ilizarov Technique. The lower femur deformity correction and deformity correction of upper tibia and lengthening were carried out simultaneously. This case demonstrates an approach to large complex post-traumatic deformity in the left knee region with puckering of the skin and bad scar.

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Radiographic Outcomes, Union Rates, and Complications Associated With Plantar Implant Positioning for Midfoot Arthrodesis

Foot & Ankle Orthopaedics ◽

10.1177/24730114211027115 ◽

2021 ◽

Vol 6 (3) ◽

pp. 247301142110271

Author(s):

Tyler W. Fraser ◽

Daniel T. Miles ◽

Neal Huang ◽

Franklin B. Davis ◽

Burton D. Dunlap ◽

...

Keyword(s):

Hallux Valgus ◽

Skin Irritation ◽

Case Series ◽

Deformity Correction ◽

Valgus Deformity ◽

Union Rate ◽

Radiographic Outcomes ◽

Hallux Valgus Deformity ◽

Metatarsal Angle ◽

Radiographic Union

Background: Midfoot arthrodesis has long been successfully included in the treatment paradigm for a variety of pathologic foot conditions. A concern with midfoot arthrodesis is the rate of nonunion, which historically has been reported between 5% and 10%. Plantar plating has also been noted to be more biomechanically stable when compared to traditional dorsal plating in previous studies. Practical advantages of plantar plating include less dorsal skin irritation and the ability to correct flatfoot deformity from the same medial incision. The purpose of this study is to report the arthrodesis rate, the success of deformity correction, and the complications associated with plantar-based implant placement for arthrodesis of the medial column. Methods: A retrospective review was undertaken of all consecutive patients between 2012 and 2019 that underwent midfoot arthrodesis with plantar-positioned implants. Radiographic outcomes and complications are reported on 62 patients who underwent midfoot arthrodesis as part of a correction for hallux valgus deformity, flatfoot deformity, degenerative arthritis, Lisfranc injury, or Charcot neuroarthropathy correction. Results: Statistically significant improvement was seen in the lateral talus–first metatarsal angle (Meary angle) and medial arch sag angle for patients treated for flatfoot deformity correction. In patients treated for hallux valgus deformity, there was a reduction in the intermetatarsal angle from 15.4 to 6.8 degrees. The overall nonunion rate was 6.45% in all patients. The rate of nonunion was higher at the NC joint compared to the TMT joint and with compression claw plates. One symptomatic nonunion required revision surgery (1.7%). There were no nonunions when excluding neuroarthropathy patients and smokers. The odds ratio (OR) for nonunion in patients with neuroarthropathy was 6.05 ( P < .05), and in active smokers the OR was 2.33 ( P < .05). Conclusion: Plates placed on the plantar bone surface for midfoot arthrodesis achieved and maintained deformity correction with rare instances of symptomatic hardware for a variety of orthopedic conditions. An overall clinical and radiographic union rate of 94% was achieved. The radiographic union rate improved to 100% when excluding both neuroarthropathy patients and smokers. The incidence of nonunion was higher in smokers, neuroarthropathy patients, naviculocuneiform joint fusions, use of compression claw plates, and when attempting to fuse multiple joints. Incisional healing complications were rarely seen other than in active smokers. Level of Evidence: Level IV, case series.

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Temporary hemiepiphysiodesis using an eight‐plate implant for coronal angular deformity around the knee in children aged less than 10 years: efficacy, complications, occurrence of rebound and risk factors

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03915-w ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Zhen-Zhen Dai ◽

Zhen-Peng Liang ◽

Hao Li ◽

Jing Ding ◽

Zhen-Kai Wu ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Deformity Correction ◽

Genu Valgum ◽

Angular Deformity ◽

Screw Loosening ◽

Logistic Regression Models ◽

The Mean ◽

Low Incidence ◽

Angular Deformities

Abstract Background Temporary hemiepiphysiodesis (TH) using an eight-Plate implant is one of the most common surgeries used for the correction of coronal angular deformities around the knee in adolescents. However, few studies have focused on children aged less than 10 years treated with TH using an eight-Plate implant. The purpose of this study was to investigate the efficacy, correction velocity, and complications of TH with an eight-Plate implant as well as the occurrence of rebound and risk factors in this population. Methods This retrospective study included a total of 135 physes (101 knees) from 66 children (mean age of 4.69 years old, range from 1 to 10 years old) who underwent TH with an eight-Plate implant to correct coronal genu angular deformities in our hospital. Related clinical factors were recorded and analysed by multivariable linear and logistic regression models. Results The mean deformity correction period was 13.26 months, and the mean follow-up after eight-Plate removal was 12.71 months. In all, 94.06% (95/101 knees) of the genu angular deformities were completely corrected. Non-idiopathic genu angular deformity was found to be an independent risk factor for deformity correction failure (odds ratio (OR) = 2.47). The femoral correction velocity was significantly higher than the tibial correction velocity (1.28° vs. 0.83° per month, p < 0.001). After adjustment for other factors, younger children had higher correction velocities in the distal femur; however, genu valgum and idiopathic deformities were associated with higher correction velocities in the proximal tibia. In addition, we found three (3/101, 2.97%) knees with genu valgum that experienced rebound after removal of the eight-Plate, while five (5/101, 4.95%) knees with non-idiopathic genu angular deformity experienced screw loosening. No other complications were found, and non-idiopathic deformity was the only risk factor for complications (OR = 3.96). No risk factor was found for rebound in our study. Conclusions TH using an eight-Plate implant is an effective procedure for coronal genu angular deformities with a low incidence of complications and rebound in patients younger than 10 years old. For this population, TH using an eight-Plate should be considered as soon as the deformity stops responding to conservative treatments. The parents of children younger than 10 years of age with non-idiopathic deformities should be informed preoperatively that the deformity may be prone to correction failure or screw loosening after eight-Plate implantation.

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Increased Displacement Maximizes the Utility of the Distal Chevron Osteotomy for Hallux Valgus Deformity Correction

Foot & Ankle International ◽

10.3113/fai.2008.0155 ◽

2008 ◽

Vol 29 (2) ◽

pp. 155-163 ◽

Cited By ~ 24

Author(s):

Daniel E. Murawski ◽

James L. Beskin

Keyword(s):

Hallux Valgus ◽

Deformity Correction ◽

Valgus Deformity ◽

Chevron Osteotomy ◽

Hallux Valgus Deformity

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Monomelic Maffucci syndrome

BMJ Case Reports ◽

10.1136/bcr-2020-239619 ◽

2021 ◽

Vol 14 (3) ◽

pp. e239619

Author(s):

Gopalkrishna G Verma ◽

Vijay Kumar Jain ◽

Karthikeyan P Iyengar

Keyword(s):

Lower Limb ◽

Corrective Osteotomy ◽

Valgus Deformity ◽

Left Knee ◽

Leg Length ◽

Maffucci Syndrome ◽

Successful Clinical Outcome ◽

Genu Valgus Deformity ◽

Angular Deformities

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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Lengthening and Deformity Correction of the Upper Extremity by the Ilizarov Technique

Orthopedic Clinics of North America ◽

10.1016/s0030-5898(20)31701-6 ◽

1991 ◽

Vol 22 (4) ◽

pp. 689-713 ◽

Cited By ~ 1

Author(s):

Kevin Tetsworth ◽

Jonathan Krome ◽

Dror Paley

Keyword(s):

Upper Extremity ◽

Deformity Correction ◽

Ilizarov Technique

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Ilizarov technique and limited surgical methods for correction of post-traumatic talipes equinovarus in children

ANZ Journal of Surgery ◽

10.1111/ans.14123 ◽

2017 ◽

Vol 87 (10) ◽

pp. 815-819 ◽

Cited By ~ 1

Author(s):

Xiao Jian Wang ◽

Feng Chang ◽

Yunxing Su ◽

Bin Chen ◽

Jie-Fu Song ◽

...

Keyword(s):

Ilizarov Technique ◽

Surgical Methods ◽

Talipes Equinovarus ◽

Post Traumatic

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20 Degree Post Traumatic Ankle Valgus and Distal Lateral Tibial Osteonecrosis Treated with Staged Deformity Correction and Total Ankle Arthroplasty

Foot & Ankle Orthopaedics ◽

10.1177/2473011417s000159 ◽

2017 ◽

Vol 2 (3) ◽

pp. 2473011417S0001

Author(s):

Lawrence DiDomenico ◽

Danielle Butto

Keyword(s):

Ankle Joint ◽

Deformity Correction ◽

Total Ankle Arthroplasty ◽

Wedge Osteotomy ◽

Tibial Osteotomy ◽

Opening Wedge ◽

Ankle Arthroplasty ◽

Initial Surgery ◽

Post Traumatic ◽

Ankle Valgus

Category: Ankle, Ankle Arthritis Introduction/Purpose: The purpose of this review is to present a case of post-traumatic ankle valgus and distal lateral tibial osteonecrosis successfully treated with staged deltoid repair, opening wedge tibial osteotomy, fibular lengthening, syndesmotic fusion and total ankle arthroplasty. Methods: Initial surgery consisted of ankle joint arthrotomy and deltoid imbrication. The second surgery consisted of a tibial opening wedge osteotomy with autogenous cortical fibular bone graft superior to the area of osteonecrosis to correct the 20 degree ankle valgus. Fibular lengthening osteotomy and fusion of the distal syndesmosis were also performed. CT scan confirmed bony consolidation at the distal tibiofibular syndesmosis as well as union of the allograft opening wedge. The final surgery was total ankle joint replacement with bone grafting of the area of osteonecrosis. Results: After 5 years of follow up the patient has progressed out of his AFO to full weightbearing. He reports no ankle pain, improved function and range of motion and is ambulating independently with no assistive devices. Conclusion: We successfully treated a case of distal lateral tibial osteonecrosis, and a 20 degree ankle valgus with staged deformity correction and ankle replacement. Radiographs demonstrate a well seated and positioned implant. We believe that with proper alignment that total ankle arthroplasty is a safe treatment option in the face of bone infarction.

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Comparison of Postoperative Height Changes of the Second Metatarsal Among 3 Osteotomy Methods for Hallux Valgus Deformity Correction

Foot & Ankle International ◽

10.1177/1071100716666566 ◽

2016 ◽

Vol 38 (1) ◽

pp. 20-26 ◽

Cited By ~ 5

Author(s):

Jun Young Choi ◽

Yu Min Suh ◽

Ji Woong Yeom ◽

Jin Soo Suh

Keyword(s):

Hallux Valgus ◽

Deformity Correction ◽

Metatarsal Head ◽

Valgus Deformity ◽

Metatarsal Osteotomy ◽

Level Of Evidence ◽

First Metatarsal ◽

Scarf Osteotomy ◽

Hallux Valgus Deformity ◽

Second Metatarsal

Background: We aimed to compare the postoperative height of the second metatarsal head relative to the first metatarsal head using axial radiographs among 3 different commonly used osteotomy techniques: proximal chevron metatarsal osteotomy (PCMO), scarf osteotomy, and distal chevron metatarsal osteotomy (DCMO). Methods: We retrospectively reviewed the radiographs and clinical findings of the patients with painful callosities under the second metatarsal head, complicated by hallux valgus, who underwent isolated PCMO, scarf osteotomy, or DCMO from February 2005 to January 2015. Each osteotomy was performed with 20 degrees of plantar ward obliquity. Along with lateral translation and rotation of the distal fragment to correct the deformity, lowering of the first metatarsal head was made by virtue of the oblique metatarsal osteotomy. Results: Significant postoperative change in the second metatarsal height was observed on axial radiographs in all groups; this value was greatest in the PCMO group (vs scarf: P = .013; vs DCMO: P = .008) but did not significantly differ between the scarf and DCMO groups ( P = .785). The power for second metatarsal height correction was significantly greater in the PCMO group (vs scarf: P = .0005; vs DCMO: P = .0005) but did not significantly differ between the scarf and DCMO groups ( P = .832). Conclusions: Among the 3 osteotomy techniques commonly used to correct hallux valgus deformity, we observed that PCMO yielded the most effective height change of the second metatarsal head. Level of Evidence: Level III, retrospective comparative series.

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