Distal Femoral Osteotomy
In this text, we describe our preferred operative method for a lateral opening wedge varus-producing distal femoral osteotomy to right mild to reasonable valgus malalignment. Video 1 The video describes our most popular method for lateral opening wedge distal femoral osteotomy. PearlsRadiolucent retractors enable fluoroscopic visualization whereas the osteotomy is carried out.The surgeon ought to mark the noticed 5-10 mm shorter than the length 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 should be carried out to keep away from fracture of the lateral cortex.
For a medial closing wedge osteotomy, a wedge-shaped part of bone is eliminated, and the opening is closed by bringing the minimize ends of the bones together, thus altering the alignment of the bones. We have found that performing the distal femoral osteotomy and the MCL reconstruction at the identical time is profitable and does not require two separate reconstructions. Calculations of the particular amount of opening that’s wanted utilizing the present digital x-ray techniques are very accurate. Concurrent with this, a plate and screws are positioned on the skin of the knee and bone graft is positioned into the opening wedge which is created to assist with therapeutic of the gap. The wedge measurement can be deliberate before surgical procedure and confirmed intraoperatively.
Femoral Distal Opening And Closing Wedge Osteotomy :
Diagnostic arthroscopy can be used to evaluate for associated meniscoligamentous or cartilage injuries for concomitant procedures with the osteotomy. The denoted buildings represent 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 through 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 levels of malalignment is the brink to think about osteotomy.
- The technique presented in this article offers a secure, reproducible methodology to carry out the medial closing-wedge DFO.
- The success charges for lateral meniscal transplants and cartilage resurfacing procedures are much much less if the valgus alignment is not corrected with the surgical process .
- Corticocancellous wedges are harvested from the femoral neck portion of an allograft femoral head and placed into the osteotomy web site according to the preoperative plan.
- The diaphyseal midline was marked with an electrocautery and a Codman pen to keep away from angular deviation in the course of the stabilization of the plaque.
Sports-associated accidents and motor vehicle accidents are at present the most typical causes of injury. Proper care of these injuries consists of counseling sufferers and fogeys concerning the future chance of progress-associated issues. Among them, Salter-Harris sort II is the most common, making up about half of progress plate fractures, whereas varieties IV and V are rare, accounting for only some % . Distal femoral perichondral ring harm (SH sort VI, Rang’s kind VI) is a comparatively rare injury and is understood to result in a high prevalence of growth issues with angular deformity . However, the timing of remedy and approaches to therapy have yet to be established.