Kyung Wook Nha1, Soon Hyuck Lee2, Im Joo Rhyu3, Hak Jun Kim4, Jae Gwang Song1, Jae Hwi Han1, Eui Dong Yeo5, Young Koo Lee6. 1. Department of Orthopedic Surgery, Inje University Ilsanpaik Hospital, Republic of Korea. 2. Department of Orthopedic Surgery, Korea University Anam Hospital, Republic of Korea. 3. Department of Anatomy, College of Medicine, Korea University, Republic of Korea. 4. Department of Orthopedic surgery, Korea University Guro Hospital, Republic of Korea. 5. Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, Republic of Korea. 6. Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital, Republic of Korea brain0808@hanmail.net.
Abstract
BACKGROUND: The purpose of this present study was to determine the incidence of lateral cortical fracture depending on the plane of osteotomy in medial open-wedge supramalleolar osteotomy (SMO) and to define a safe zone through which a medial open-wedge SMO could be performed with minimal risk of lateral cortical fracture. MATERIALS AND METHODS: Matched pairs of fresh-frozen human cadaver lower leg specimens were obtained from 7 males and 3 females (average age = 63.9 [range 49-75] years). In group A, a safe zone-level medial open-wedge SMO (plane of osteotomy oriented to the proximal one-third of the intrasyndesmosis) was performed, and in group B, a higher-level medial open-wedge SMO (plane of osteotomy oriented to the suprasyndesmosis) was performed. RESULTS: In group A, 7 of the 10 limbs had no lateral cortical fracture, and 3 had lateral cortical fracture, but all of the fractured limbs were stable during the medial open-wedge SMO procedure. In group B, 2 of 10 limbs had no lateral cortical fracture and 8 had lateral cortical fracture. Three of the 8 fractured limbs were stable, but 5 were unstable during the medial open-wedge SMO procedure. The incidence of lateral cortical fracture in group B was significantly higher compared to group A (P = .04). CONCLUSIONS: According to the present findings, lateral cortical fracture was less likely to occur when open-wedge SMO was at the plane of the proximal one-third of the intrasyndesmosis, the so-called "safe zone," than at the plane of the suprasyndesmosis. CLINICAL RELEVANCE: A safe zone for medial open-wedge SMO to prevent lateral cortical fracture during the medial open-wedge SMO procedure was identified.
BACKGROUND: The purpose of this present study was to determine the incidence of lateral cortical fracture depending on the plane of osteotomy in medial open-wedge supramalleolar osteotomy (SMO) and to define a safe zone through which a medial open-wedge SMO could be performed with minimal risk of lateral cortical fracture. MATERIALS AND METHODS: Matched pairs of fresh-frozen human cadaver lower leg specimens were obtained from 7 males and 3 females (average age = 63.9 [range 49-75] years). In group A, a safe zone-level medial open-wedge SMO (plane of osteotomy oriented to the proximal one-third of the intrasyndesmosis) was performed, and in group B, a higher-level medial open-wedge SMO (plane of osteotomy oriented to the suprasyndesmosis) was performed. RESULTS: In group A, 7 of the 10 limbs had no lateral cortical fracture, and 3 had lateral cortical fracture, but all of the fractured limbs were stable during the medial open-wedge SMO procedure. In group B, 2 of 10 limbs had no lateral cortical fracture and 8 had lateral cortical fracture. Three of the 8 fractured limbs were stable, but 5 were unstable during the medial open-wedge SMO procedure. The incidence of lateral cortical fracture in group B was significantly higher compared to group A (P = .04). CONCLUSIONS: According to the present findings, lateral cortical fracture was less likely to occur when open-wedge SMO was at the plane of the proximal one-third of the intrasyndesmosis, the so-called "safe zone," than at the plane of the suprasyndesmosis. CLINICAL RELEVANCE: A safe zone for medial open-wedge SMO to prevent lateral cortical fracture during the medial open-wedge SMO procedure was identified.
Authors: Julia Greenfield; Philipp Appelmann; Yoann Lafon; Karine Bruyère-Garnier; Pol Maria Rommens; Sebastian Kuhn Journal: Sci Rep Date: 2021-09-22 Impact factor: 4.379
Authors: Hak Jun Kim; Eui Dong Yeo; Im Joo Rhyu; Soon-Hyuck Lee; Yeon Soo Lee; Young Koo Lee Journal: BMC Musculoskelet Disord Date: 2017-09-09 Impact factor: 2.362