S-design osteotomy and internal fixation for multiplanar and acute correction of deformity in infantile Blount's disease - preliminary results from single centre series.

IF 2.6 3区医学 Q2 ORTHOPEDICS International Orthopaedics Pub Date : 2025-03-01 Epub Date: 2025-02-13 DOI:10.1007/s00264-025-06427-1

Aryadi Kurniawan, Omar Luthfi, Juniarto Jaya Pangestu, Witantra Dhamar Hutami

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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.

Level of evidence: V.

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s型截骨内固定治疗婴幼儿布朗特病多平面畸形和急性畸形矫治——单中心研究的初步结果

目的：这是一项短期随访的初步研究，以确定s型截骨内固定治疗婴儿布朗特病急性内翻和旋转矫正技术的安全性和有效性。方法：我们在我们的机构医院进行了回顾性的系列研究。对布朗特病患者行s型截骨术进行多平面急性矫正后内固定。通过比较术前和术后胫股角（TFA）和干骺端角（MDA）来衡量疗效。安全性由术后发生的神经功能缺损和室间综合征的数量决定。使用下肢功能量表（LEFS）评估功能结局。所有患者术后随访一年。结果：本研究纳入19例患者（共31条肢体），分为TFA小于40度（A组）和大于40度（B组），两组均未出现神经功能缺损和筋膜室综合征。无论术前畸形的严重程度如何，两组均获得了显著的矫正。术后A组与B组TFA（分别为1.70、3.00，p值为0.147）、MDA（分别为4,60、6,0，p值为0.327）差异无统计学意义。这表明术前畸形与术后结果之间没有相关性。A组LEFS评分（73.85±2.73），B组LEFS评分（73.85±2.73），两组均较好（p = 0.293）。结论：本初步研究和短期随访表明s型截骨术在增加肢体长度的同时有效地纠正了内旋和内翻。在两根水平截骨线（近端和远端）之间行盒状截骨术，可实现内旋矫正，效果安全有效。急性矫治是治疗严重布朗特病安全有效的方法。等待长期随访。证据等级:V。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Orthopaedics 医学-整形外科

CiteScore

5.50

自引率

7.40%

发文量

360

审稿时长

1 months

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.