Jatin Prakash1, Tankeswar Boruah1, Anil Mehtani2, Suresh Chand2, Hitesh Lal1. 1. Central Institute of Orthopaedics, Safderjung Hospital and VMMC, Delhi-29, India. 2. Department of Orthopaedics, Lady Hardinge medical College, Shaheed Bhagat Singh Marg, New Delhi-110002, India.
Abstract
PURPOSE: Medial close wedge Coventry type osteotomy is commonly performed procedure for adoloscent Genu valgum. However this osteotomy has some inherent problems, a wedge resection causes shortening of affected site. An additional plate for stabilization causes increase in soft tissue dissection and surgical time. A cheveron osteotomy is an alternative procedure, not requiring any internal fixation due to its inherent stability. We started this study with aim to analyze the results of Cheveron osteotomy, to see if the osteotomy was stable enough without implants, time required for healing of osteotomy, post-operative range of motion, limb length discrepancy and to evaluate any other complication. METHODS: This study was conducted to evaluate the efficacy of cheveron osteotomy in cases with genu valgum in our department from 2005 to 2012. 75 children with 115 knee deformities were included in the study. Patients were followed upto minimum 3 years post surgery. Clinical and radiological assessment was done on all subsequent visits. RESULTS: Preoperative mean valgus angle was 21° (12-30°) and mean inter malleolar distance was 12.3 cm(11-21 cm). The mean post-operative angle was 6.5° and mean intermalleolar distance was 5.6 cm. The difference was statistically significant. The mean tourniquet time was 26 min and mean surgical time including plaster cast application was 38 min. Mean blood loss was 75 ml. The mean time to union was 10.3 weeks. CONCLUSION: Supracondylar cheveron osteotomy is simple, stable, low cost osteotomy for surgical correction of genu valgum. The osteotomy provides excellent clinical, radiological and functional results in short surgical time and has an added advantage of omitting the need of second surgery.
PURPOSE: Medial close wedge Coventry type osteotomy is commonly performed procedure for adoloscent Genu valgum. However this osteotomy has some inherent problems, a wedge resection causes shortening of affected site. An additional plate for stabilization causes increase in soft tissue dissection and surgical time. A cheveron osteotomy is an alternative procedure, not requiring any internal fixation due to its inherent stability. We started this study with aim to analyze the results of Cheveron osteotomy, to see if the osteotomy was stable enough without implants, time required for healing of osteotomy, post-operative range of motion, limb length discrepancy and to evaluate any other complication. METHODS: This study was conducted to evaluate the efficacy of cheveron osteotomy in cases with genu valgum in our department from 2005 to 2012. 75 children with 115 knee deformities were included in the study. Patients were followed upto minimum 3 years post surgery. Clinical and radiological assessment was done on all subsequent visits. RESULTS: Preoperative mean valgus angle was 21° (12-30°) and mean inter malleolar distance was 12.3 cm(11-21 cm). The mean post-operative angle was 6.5° and mean intermalleolar distance was 5.6 cm. The difference was statistically significant. The mean tourniquet time was 26 min and mean surgical time including plaster cast application was 38 min. Mean blood loss was 75 ml. The mean time to union was 10.3 weeks. CONCLUSION: Supracondylar cheveron osteotomy is simple, stable, low cost osteotomy for surgical correction of genu valgum. The osteotomy provides excellent clinical, radiological and functional results in short surgical time and has an added advantage of omitting the need of second surgery.