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Treatment of genu valgum by a novel percutaneous transverse metaphyseal osteotomy of the distal femur in children and adolescents

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the outcomes of a novel percutaneous medial supracondylar femoral osteotomy and above-knee cast technique in children and adolescents as a minimally invasive surgical intervention for treatment of genu valgum.

Methods

In this prospective study, 60 patients (70 knees) with a tibiofemoral angle more than 15° were treated with a novel medial percutaneous supracondylar femoral osteotomy and above-knee cast and followed up for an average of 29 months. The radiological outcome was measured with MAD, TFA, and mLDFA. The functional outcome was evaluated by a modified Böstman score.

Results

The preoperative mean MAD, TFA, and mLDFA were 2.9 cm, 16.3°, and 79.2° respectively. The Böstman score averaged preoperatively 23.1. There was a significant improvement of all radiological and clinical outcome measures (P < 0.001). Per Böstman score, 2 knees in one patient (3%) showed an unsatisfactory result, while 14 (20%) and 54 (77%) knees had a good or excellent result, respectively. Two patients (three limbs) needed early re-casting. Other complications were not encountered.

Conclusion

In experienced hands, percutaneous transverse metaphyseal femoral osteotomy and above-knee casting appear to be a safe, supracondylar cost-effective, and reliable minimally invasive acute correction technique in genu valgum in children and adolescents.

Level of evidence

Level IV—therapeutic.

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Funding

The authors state that they did not receive any public or private funding for this study, whatsoever.

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Authors and Affiliations

  1. Orthopaedic Surgery Department, Cairo University, Cairo, Egypt

    Ahmed Samir Barakat, Amr Arafa, Mohamed Tageldeen Mohamed, Abo Bakr Zein, Ahmed Afifi, Hassan El Barbary, Atef Hanna & Mohamed Hegazy

  2. The National Institute of the Neuromotor System, Imbaba, Giza, Egypt

    Joseph Salah Farah Wanas

  3. Klinik Für Unfallchirurgie, Medizinische Hochschule, Hannover, Germany

    Ahmed Hosny Khalifa

Authors
  1. Ahmed Samir Barakat
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  2. Amr Arafa
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  3. Mohamed Tageldeen Mohamed
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  4. Abo Bakr Zein
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  5. Ahmed Afifi
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  6. Joseph Salah Farah Wanas
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  7. Hassan El Barbary
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  8. Atef Hanna
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  9. Mohamed Hegazy
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  10. Ahmed Hosny Khalifa
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Contributions

The authors declare that they have equally contributed to this submission.

Corresponding author

Correspondence to Ahmed Afifi.

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Conflict of interest

All authors declare that there are no conflicts of interest regarding any companies or devices mentioned in this study.

Ethics approval

This study was approved by the relevant institutional ethical board and was in full compliance with the Declaration of Helsinki and its appendages.

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Full and detailed informed and written consent was obtained from the patients or their caregivers to participate in this study.

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Full and detailed informed and written consent was obtained from the patients or their caregivers to publish their anonymized data. Publication of potentially identifying data as names, addresses, images, etc. is prohibited.

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Barakat, A.S., Arafa, A., Mohamed, M.T. et al. Treatment of genu valgum by a novel percutaneous transverse metaphyseal osteotomy of the distal femur in children and adolescents. Eur J Orthop Surg Traumatol 32, 1179–1186 (2022). https://doi.org/10.1007/s00590-021-03093-y

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  • DOI: https://doi.org/10.1007/s00590-021-03093-y

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