Oblique Single-Cut Rotation Osteotomy for Correction of Femoral Varus-Torsional Deformities in 3D-Reconstructed Canine Bone Models

Abstract Purpose Osteotomies represent well-established treatment-options for the redistribution of loads and forces within and around the knee-joint. Effects of these osteotomies on the remaining planes and adjacent joints are not fully understood. The aim of this study was to determine the influence of a distal-femoral-rotation-osteotomy on the coronal alignment of the ankle. It was hypothesized that supracondylar-external-rotation-osteotomy of the distal femur leads to a change in the coronal orientation of the ankle joint. Methods Long-leg standing radiographs and CT-based torsional measurements of 27 patients undergoing supracondylar-rotational-osteotomy of the femur between 2012 and 2019 were obtained and utilized for the purpose of this study. Postoperative radiographs were obtained after union at the osteotomy-site. The hip-knee-ankle-angle (HKA), the mechanical-lateral-distal-femur-angle (mLDFA), and Tibia-Plafond-Horizontal-Orientation-Angle (TPHA) around the ankle were measured. Comparison between means was performed using the Wilcoxon-Mann–Whitney test. Results Twenty-seven patients with high femoral antetorsion (31.3° ± 4.0°) underwent supracondylar-external-rotation-osteotomy. The osteotomy led to a reduced antetorsion (17.4 ± 5.1; p < 0.001) and to a valgisation of the overall limb-alignment. The HKA decreased by 2.4° ± 1.4° (p < 0.001). The TPHA decreased by 2.6° (p < 0.001). Conclusions Supracondylar external rotation osteotomy of the femur leads to lateralization of the weight bearing line at the knee and ankle due to valgisation of the coronal limb alignment. The mobile subtalar joint has to compensate (inversion) for the resulting valgus orientation of the ankle to ensure contact between the foot and the floor. When planning a rotational osteotomy of the lower limb, this should be appreciated – especially in patients with a preexisting valgus alignment of the lower extremities or restricted mobility in the subtalar joint.

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Soft tissue rebalancing procedures with and without internal rotation osteotomy for shoulder deformity in children with persistent obstetric brachial plexus palsy

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-010-1067-6 ◽

2010 ◽

Vol 130 (12) ◽

pp. 1499-1504 ◽

Cited By ~ 5

Author(s):

Marcin Sibiński ◽

Marek Synder

Keyword(s):

Soft Tissue ◽

Brachial Plexus ◽

Internal Rotation ◽

Brachial Plexus Palsy ◽

Obstetric Brachial Plexus Palsy ◽

Obstetric Brachial Plexus ◽

Shoulder Deformity ◽

Rotation Osteotomy

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Congenital Radio-Ulnar Synostosis: Compensatory Rotation around the Wrist and Rotation Osteotomy.

Journal of Hand Surgery (European Volume) ◽

10.1016/0266-7681_87_90006-4 ◽

1987 ◽

Vol 12 (2) ◽

pp. 173-178

Author(s):

T. OGINO ◽

K. HIKINO

Keyword(s):

Clinical Features ◽

Daily Life ◽

Functional Results ◽

Rotational Osteotomy ◽

Compensatory Movement ◽

The Mean ◽

Almost All ◽

Rotation Osteotomy

In order to make clear the clinical features of congenital radio-ulnar synostosis, compensatory rotation around the wrist and functional results after rotation osteotomy, 40 cases of congenital radio-ulnar synostosis have been analysed. The mean pronation of the ankylosed forearm in those who complained of disabilities in daily life was 60.7° and that in patients without complaints was 21.2°. In almost all cases with total ankylosis, the forearm had compensatory movement around the wrist, the mean arc being from 76.3° of pronation to 42.9° of supination. 13 limbs in 11 patients treated by transverse rotational osteotomies through the fusion mass have followed up for over two years. The functional results after surgery were satisfactory in all patients. Rotational osteotomy of the forearm is a useful and reliable treatment for congenital radio-ulnar synostosis.

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Ankle joint dorsi-plantar flexion and recurrence after femoral de-rotation osteotomy

Gait & Posture ◽

10.1016/j.gaitpost.2021.09.114 ◽

2021 ◽

Vol 90 ◽

pp. 221-222

Author(s):

F. Salami ◽

M. Goetze ◽

M. Thielen ◽

S.I. Wolf

Keyword(s):

Ankle Joint ◽

Plantar Flexion ◽

Rotation Osteotomy

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Rotation osteotomy of the proximal humerus to stabilise the shoulder. Five years' experience

Journal of Bone and Joint Surgery - British Volume ◽

10.1302/0301-620x.77b6.7593108 ◽

1995 ◽

Vol 77-B (6) ◽

pp. 924-927 ◽

Cited By ~ 10

Author(s):

M Kronberg ◽

LA Brostrom

Keyword(s):

Proximal Humerus ◽

Rotation Osteotomy

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Stabilisation of the hip in myelomeningocele. Comparison of posterior iliopsoas transfer and varus-rotation osteotomy

Journal of Bone and Joint Surgery - British Volume ◽

10.1302/0301-620x.70b1.3339055 ◽

1988 ◽

Vol 70-B (1) ◽

pp. 29-33 ◽

Cited By ~ 15

Author(s):

H Weisl ◽

JA Fairclough ◽

DG Jones

Keyword(s):

Rotation Osteotomy

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Can rotation osteotomy remain effective for more than ten years?

Orthopedic Clinics of North America ◽

10.1016/j.ocl.2004.03.001 ◽

2004 ◽

Vol 35 (3) ◽

pp. 345-351 ◽

Cited By ~ 2

Author(s):

Frantz Langlais ◽

Jacques Fourastier ◽

Jean Emmanuel Gédouin ◽

Mickaël Ropars ◽

Jean Christophe Lambotte ◽

...

Keyword(s):

Rotation Osteotomy

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External Rotation Osteotomy of Femur in Patients with Spastic Cerebral Palsy

Journal of Musculoskeletal Research ◽

10.1142/s0218957798000020 ◽

1998 ◽

Vol 02 (01) ◽

pp. 1-8

Author(s):

Ken N. Kuo ◽

David W. Hang ◽

Peter A. Smith

Keyword(s):

Cerebral Palsy ◽

Internal Rotation ◽

External Rotation ◽

Spastic Cerebral Palsy ◽

Femoral Torsion ◽

Younger Patients ◽

Foot Progression Angle ◽

Kinematic Study ◽

Rotation Osteotomy

Fifteen subjects with ambulatory spastic cerebral palsy underwent proximal femoral external rotation osteotomy between 1990 to 1992 for severe intoeing gait due to internal femoral torsion. Among them 13 patients returned for follow-up. Preoperatively, maximum internal rotation of the hip on physical examination corrected from 77° to 50° postoperatively. Foot progression angle changed from 10° intoeing gait preoperatively to 9° outtoeing gait postoperatively ( p < 0.05). The recurrence rate for internal femoral torsion after correction is 9.5 degrees/year for the group of 10-year-olds and younger, and 2.1 degrees/year for the group older than 10-year-olds. In the kinematic study, foot progression angle changed from internal rotation of 9.2° to external rotation of 16.5° ( p < 0.05). Our study showed that external rotation osteotomy of the femur is a safe and effective procedure. The rate of recurrence for femoral internal torsion was greater for younger patients (≤10-year-old) when the surgery was performed.

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