Distal Femoral Osteotomy Seattle, Wa
In this article, we describe our most well-liked operative approach for a lateral opening wedge varus-producing distal femoral osteotomy to right delicate to average valgus malalignment. Video 1 The video describes our most popular technique for lateral opening wedge distal femoral osteotomy. PearlsRadiolucent retractors enable fluoroscopic visualization whereas the osteotomy is carried out.The surgeon ought to mark the saw 5-10 mm shorter than the length of the wire to avoid plunging and violating the lateral cortex. Two separate marks could also be used to correspond to the lengths of the anterior and posterior wires, respectively.Gentle and/or sluggish closing of the osteotomy gap should be carried out to avoid fracture of the lateral cortex.
For a medial closing wedge osteotomy, a wedge-shaped part of bone is removed, and the opening is closed by bringing the cut ends of the bones collectively, thus changing the alignment of the bones. We have found that performing the distal femoral osteotomy and the MCL reconstruction on the same time is successful and does not require two separate reconstructions. Calculations of the specific amount of opening that is needed utilizing the current digital x-ray methods are very accurate. Concurrent with this, a plate and screws are placed on the skin of the knee and bone graft is positioned into the opening wedge which is created to help with healing of the gap. The wedge size can be planned earlier than surgery and confirmed intraoperatively.
Femoral Distal Opening And Shutting Wedge Osteotomy :
Diagnostic arthroscopy can be used to assess for associated meniscoligamentous or cartilage accidents for concomitant procedures with the osteotomy. The denoted constructions characterize the lateral femoral condyle , the lateral meniscus , and the lateral tibial plateau . The objective of surgical procedure is to re-create impartial alignment, such that the mechanical axis line passes by way of the center of the knee.three The amount of correction is calculated based on the angle formed between the mechanical axis of the femur and tibia . Practically, 5 levels of malalignment is the edge to think about osteotomy.
- The approach presented in this article supplies a safe, reproducible technique to perform the medial closing-wedge DFO.
- The success rates for lateral meniscal transplants and cartilage resurfacing procedures are a lot much less if the valgus alignment is not corrected with the surgical procedure .
- Corticocancellous wedges are harvested from the femoral neck portion of an allograft femoral head and placed into the osteotomy web site based on the preoperative plan.
- The diaphyseal midline was marked with an electrocautery and a Codman pen to avoid angular deviation in the course of the stabilization of the plaque.
Sports-related injuries and motor vehicle accidents are currently the most common causes of injury. Proper care of those accidents consists of counseling patients and parents concerning the future chance of growth-associated complications. Among them, Salter-Harris sort II is the commonest, making up about half of growth plate fractures, whereas varieties IV and V are rare, accounting for just a few p.c . Distal femoral perichondral ring harm (SH sort VI, Rang’s type VI) is a relatively uncommon harm and is understood to result in a high prevalence of growth problems with angular deformity . However, the timing of treatment and approaches to treatment have yet to be established.