Distal Femoral Osteotomy in Genovalgum: Internal Fixation with Blade Plate Versus Casting

Background:   To compare the results of two different ways of distal femoral osteotomy stabilization in patients suffering from genuvalgum: internal fixation with plate, and casting. Methods:   In a non-randomized prospective study, after distal femoral osteotomy with the zigzag method, patients were divided into two groups: long leg casting, and internal fixation with blade plate. For all patients, questionnaires    were filled to obtain data. Information such as range of motion, tibiofemoral anatomical angle and complications were recorded.     Results:   ۳۸ knees with valgus deformity underwent distal femoral supracondylar osteotomy. (۸ with plaster cast and  ۳۰ with internal fixation using a blade plate). Preoperative range of motion was ۱۲۹±۶° and six months later it was  ۱۲۰±۱۴°. The preoperative tibiofemoral angle was ۳۲±۶°; postoperative tibiofemoral angles were ۳±۳°, ۶±۲°, and ۷±۳° just after operation, six months, and two years later, respectively. Although this angle was greater among the group stabilized with a cast, this difference was not statistically significant. In postoperative complications, over-correction  was found in five, recorvatom deformity in one, knee stiffness in three and superficial wound infection was recorded in three knees.     Conclusions:   There is no prominent difference in final range of motion and alignment whether fixation is done with casting or internal fixation. However, the complication rate seems higher in the casting method.    

Keywords:

Casting , Distal femoral osteotomy , Genuvalgum , Internal Fixation