Treatment of Genu Valgum Deformity in Adolescent by Closed Wedge Femoral Osteotomy

Abstract

Background: Various types of corrective osteotomies of the distal femur have been described in the literature for genu valgum deformity such as lateral opening wedge, medial closing wedge, dome osteotomy, wedgeless spike osteotomy, and wedgeless “V” osteotomy. Objectives: We aimed in this study to evaluate the effectiveness of medial closing wedge osteotomy in correction of deformity. Patients and Methods: This study was done on 32 knees (18 patients) with age ranged from 10 to 18 years with mean average of 15.61 ± 1.28 years. After recording history and physical examination, appropriate radiographs were taken. We did varus distal femoral osteotomy by standard medial subvastus approach then followed the patients clinically and radiographically. Results: Mean operation time was 139.72 ± 42.4 minutes, with minimum 90 minutes and maximum 170 minutes. The mean time to union of osteotomy was 8.9 weeks (ranged from 7 to 11 weeks). The mean preoperative tibiofemoral angle (TFA) was 16.5° (range: 12°–19°) that improved after surgery to a mean postoperative value of 2.57° (range: 1.3°–4.7°), which was statistically significant (P < 0.001). Conclusion: Distal femoral varus osteotomy can be a reliable procedure for the treatment of valgus knee deformity. In this procedure, with more tibiofemoral angle correction, more congruence angle correction can be achieved. Therefore, along with genu valgum correction, the patella should be stabilized simultaneously.