Distal Femoral Osteotomy

In this article, we describe our preferred operative approach for a lateral opening wedge varus-producing distal femoral osteotomy to appropriate delicate to average valgus malalignment. Video 1 The video describes our most popular technique for lateral opening wedge distal femoral osteotomy. PearlsRadiolucent retractors allow fluoroscopic visualization whereas the osteotomy is performed.The surgeon ought to mark the noticed 5-10 mm shorter than the size 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 slow closing of the osteotomy gap should be performed to avoid fracture of the lateral cortex.

Through acceptable indication and affected person selection, each sorts of valgisation osteotomies close to the knee joint can provide improvements in clinical function, pain stage and quality of life. These joint-preserving interventions thus represent a priceless treatment choice in varus deformities. Varus deformities of the knee are frequently corrected by osteotomies, which should be performed at the stage of origin. But in contrast to high tibial osteotomies , little knowledge exists for distal femoral osteotomies . An Osteotomy is a managed surgical break or fracture of the bone to allow realignment of the limb.

Dfo (distal Femoral Osteotomy)

Diagnostic arthroscopy can be used to evaluate for associated meniscoligamentous or cartilage injuries for concomitant procedures with the osteotomy. The denoted constructions symbolize the lateral femoral condyle , the lateral meniscus , and the lateral tibial plateau . The goal of surgery is to re-create impartial alignment, such that the mechanical axis line passes via the center of the knee.3 The amount of correction is calculated based mostly on the angle formed between the mechanical axis of the femur and tibia . Practically, 5 levels of malalignment is the brink to consider osteotomy.

• This article offers an in depth, step-sensible methodology that enables the reproducible creation of a medial closing-wedge DFO for the valgus knee using locking-plate fixation.
• They shouldn’t eat from anything after midnight the night time before, they can have water only up till 5am.
• Typically, a extra lateral skin incision is made to gain access to the lateral femoral cortex.
• Closure is then accomplished in layers with the medial patellofemoral ligament repaired if partially transected.

Bone fusion is achieved and %MA is 48.5% from the medial fringe of the tibial plateau. Severe valgus deformity is famous with an FTA of a hundred and sixty levels and a %MA of 100% from the medial edge of the tibial plateau. Limitations of this examine are the heterogeneous examine population and the low case quantity for femoral and tibial osteotomies. The expected number of instances within this cohort and the mean values and normal deviations in accuracy and scientific consequence parameters in previous studies had been too small for a prospective energy evaluation. Additionally, lengthy-term details about clinical operate or survival charges is missing. Several authors report an improvement of medical scores for as much as 5 years postoperatively after HTO.

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