S-design osteotomy and internal fixation for multiplanar and acute correction of deformity in infantile Blount's disease - preliminary results from single centre series.
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Abstract
Purpose: This is a preliminary study with short-term follow up to determine the safety and efficacy of the S-design osteotomy and internal fixation for acute varus and rotational correction technique in infantile Blount's disease.
Methods: We performed a retrospective series in our institutional hospital. An S-design osteotomy for multiplanar, acute correction followed by internal fixation was performed for Blount's disease patients. Effectiveness was measured by comparing pre-and post-operative tibiofemoral angle (TFA) and metaphyseal-diaphyseal angle (MDA). Safety was determined by the number of neurological deficits and compartment syndromes occurred post operatively. Functional outcome was assessed using the Lower Extremity Functional Scale (LEFS). All patients underwent a one-year follow-up after surgery.
Results: Nineteen patients (total of 31 extremities) were included in this study and classified into TFA less than 40 degree (group A) and more than 40 degree (group B). No neurological deficits nor compartment syndrome occured in either group. Regardless the severity of pre-operative deformity, both groups achieved significant corrections. Post operatively there was no significant difference in TFA in Group A and Group B (1.70 and 3.00 respectively, with p value of 0.147) and MDA (4,60 and 6,0 respectively, with p value of 0.327). This indicated there was no correlation between preoperative deformity and postoperative results. LEFS score of group A (73.85 ± 2.73) and Group B (73.85 ± 2.73) showed equally good results in both groups (p = 0.293).
Conclusion: This preliminary study with short-term follow up suggested that the S-design osteotomy effectively corrected internal rotation and varus while aiding limb length. The correction of internal rotation is accomodated by performing box osteotomy between the two horizontal (proximal and distal) lines of osteotomy, with safe and effective results. Acute correction is a safe and effective strategy for severe Blount's disease. Longer-term follow-up is awaited.
期刊介绍：
International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters.
Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.
Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable.
The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.
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