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Prospective comparative study of two methods for fixation after distal femur corrective osteotomy for valgus deformity; retrograde intramedullary nailing versus less invasive stabilization system plating

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Abstract

Introduction

The aim of this study was to compare the radiological and functional results of two different methods of fixation for the correction of femoral valgus deformities.

Methods

Patients who had undergone osteotomy and correction of a valgus deformity from 2007 to 2013 were prospectively followed. Thirty three patients (20 females, 13 males) with 39 lower limbs were included in the study. Seventeen lower limbs were treated with retrograde intramedullary nailing (IMN) and 22 with less invasive stabilization system plating. Standing orthoroentgenograms of the lower limbs were taken pre-operatively and at the final follow-up. mLDFA, aLDFA, mechanical axis deviation (MAD) were measured in this orthoroentgenograms. Knee osteoarthritis outcome score (KOOS) and knee range of motion were used pre-operatively and at the final follow-up as part of the evaluation of the clinical results. All patients duration of surgery, length of hospital stay were assessed. Operations were performed by two orthopedic surgeons. The choice of correction method for each patient was determined by the surgeon. Pre-operative and post-operative values were simultaneously measured by two additional orthopedic surgeons.

Results

The mean age of the patients was 26.2 years (18.0–51.0) in the plating group and 29.3 years (18.0–55.0) in the nailing group. Patients in the plating and nailing groups were followed up for 24.0 (12.0–60.0) and 27.8 (12.0–60.0) months. All patients were followed for a minimum of 12 months. No significant differences were observed between the groups in terms of age, sex, or duration of follow-up (p > 0.05) Comparison of the pre- and post-operative mLDFA, aLDFA, MAD, length of hospital stay, and duration of surgery between the plating group and nailing group, no significant difference was observed between the groups (p > 0.05). However, patients treated with retrograde IMN had significantly better post-operative results in terms of the KOOS and range of motion of the knee according to plating group (p < 0.05).

Conclusion

Retrograde IMN does not provide a radiological advantage over the LISS plating technique for valgus deformity but retrograde IMN and correction offered better functional results in cases of femoral valgus deformity than did the LISS plating method.

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Authors and Affiliations

  1. Elazığ Education and Training Hospital, İnonu Street, No 74, Elazığ, Turkey

    Çağrı Özcan

  2. Baltalimanı Bone Diseases Education and Training Hospital, Istanbul, Turkey

    Sami Sökücü, Kubilay Beng, Engin Çetinkaya, Bilal Demir & Yavuz Selim Kabukçuoğlu

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  1. Çağrı Özcan
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  2. Sami Sökücü
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  3. Kubilay Beng
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  4. Engin Çetinkaya
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  5. Bilal Demir
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  6. Yavuz Selim Kabukçuoğlu
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Correspondence to Çağrı Özcan.

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None of the sponsors had any involvement in the study design; the collection, analysis, or interpretation of the data; the writing of the manuscript; or the decision to submit the manuscript for publication.

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All authors declare that they have no financial or personal relationships with any other people or organizations that could potentially and inappropriately influence (bias) their work and conclusions.

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Özcan, Ç., Sökücü, S., Beng, K. et al. Prospective comparative study of two methods for fixation after distal femur corrective osteotomy for valgus deformity; retrograde intramedullary nailing versus less invasive stabilization system plating. International Orthopaedics (SICOT) 40, 2121–2126 (2016). https://doi.org/10.1007/s00264-016-3190-7

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  • DOI: https://doi.org/10.1007/s00264-016-3190-7

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