Philos Plate For Fixation Of Supracondylar Dome Osteotomy

  • Mohindra M Central Institute of Orthopaedics, VMMC & Safdarjung Hospital, New Delhi
  • Gautam VK Central Institute of Orthopaedics, VMMC & Safdarjung Hospital, New Delhi
  • Meena A Central Institute of Orthopaedics, VMMC & Safdarjung Hospital, New Delhi
  • Gupta N Central Institute of Orthopaedics, VMMC & Safdarjung Hospital, New Delhi
  • Desai J Central Institute of Orthopaedics, VMMC & Safdarjung Hospital, New Delhi
  • Saikia S Central Institute of Orthopaedics, VMMC & Safdarjung Hospital, New Delhi
Keywords: Genu Valgum, Dome Osteotomy, PHILOS plate

Abstract

Background: Various corrective osteotomies and different modes of fixation have been described to correct genu valgum deformity. We evaluated the results of dome osteotomy for genu valgum which was stabilized with proximal humerus internal locking system (PHILOS) plate.

Material & Methods: 39 cases of Genu Valgum deformity in 24 patients treated by dome osteotomy and fixed with PHILOS plate (15 patients had bilateral deformities and 9 patients had unilateral deformity) were evaluated clinically (intermalleolar distance and tibio-femoral angle) and radiologically (tibio-femoral angle).

Results: Pre-operative mean intermalleolar distance, clinical tibio-femoral angle and radiological tibio-femoral angle pre-operatively improved from 17.5 cm (range 11 to 24), 19.250 (range 140 to 240) and 20.90 (range 150 to 260) to postoperative 2.25 cm (range 0 to 4 cm), 7.750 (range 40 to 100) and 8.950 (range 50 to 110) respectively. The mean pre-operative LDFA was 74.850 (range 670 to 830) whereas post-operative mean value was 86.90 (range 830 to 900). The mean Bostman knee score improved significantly from 20.8 (range 18 to 22) to 29.1 (range 27 to 30). 2 patients (2 limbs) had good score i.e. between 20 to 27, while rest all the patients had excellent score between 28 to 30. Improvement in intermalleolar distance, tibio-femoral angle and LDFA was statistically significant (P< 0.001)

Conclusion: Dome osteotomy with PHILOS plate fixation is reasonable cost effective, easy, available and viable option for treatment of genu valgum with excellent short to midterm results and without complication as seen by wedge osteotomy.

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References

1. Paley D, Tetsworth K. Mechanical axis deviation of the lower limbs. Preoperative planning of uniapical angular deformities of the tibia or femur. Clin Orthop Relat Res 1992;280:48-64.
2. Espandar R, Mortazavi SM, Baghdadi T. Angular deformities of the lower limbs in children. Asian J Sports Med 2010;1(1):46-53.
3. Gautam VK, Maini L, Gupta R, Sabharwal A, Arora S. Flexion test in the coronal plane deformities of the knee. J Clin Orthop Trauma 2013;4:115-8.
4. Aglietti P, Stringa G, Buzzi R. Correction of valgus knee deformity with a supracondylar V osteotomy. Clin Orthop Relat Res 1987;217:214-20.
5. Brinkman JM, hurscheler C, Agneskirchner JD, Freiling D, Van Heerwaarden RJ. Axial and torsional stability of supracondylar femur osteotomies: biomechanical comparison of the stability of five different plate and osteotomy configurations. J Knee Surg Sports Traumatol Arthrosc 2010;19(4):579-87.
6. Dewilde TR, Dauw J, Vandenneucker H, Bellemans J. Opening wedge distal femoral varus osteotomy using the Puddu plate and calcium phosphate bone cement. Knee Surg Sports Traumatol Arthrosc 2013;21(1):249-54.
7. Dietz FR, Weinstein SL. Spike osteotomy for angular deformities of the long bones in children. J Bone Joint Surg Am 1988;70:848-52.
8. Gorji J. Genu valgum : treatment by osteotomy. Clin Orthop Relat Res 1971;81:178-80.
9. Healy WL, Anglen JO, Wasilewski SA, Krackow KA. Distal femoral varus osteotomy. J Bone Joint Surg Am 1988;70(1):102-9.
10. Lin HP. Dome shaped osteotomy with external compression fixation in treatment of genu varum and valgum deformities (in Chinese). Zhonghua WaiKe Za Zhi 1982;20(5):296-7.
11. McDermott AG, Finklestein JA, Farine I, Boynton EL, MacIntosh DL, Gross A. Distal femoral varus osteotomy for valgus deformity of the knee. J Bone Joint Surg Am 1988;70:110-6.
12. Omidi-Kashani F, Hasankhani IG, Mazlumi M, Ebrahimzadeh MH. Varus distal femoral osteotomy in young adults with valgus knee. J Orthop Surg Res 2009;4:15.
13. Puddu G, Cipolla M, Cerullo G, Franco V, Gianni E. Which osteotomy for a valgus knee? Int Orthop 2010;34:239-47.
14. Scheffer MM, Peterson HA. Opening-wedge osteotomy for angular deformities of long bones in children. J Bone Joint Surg Am 1994:76:325-34.
15. Hankemeier S, Paley D, Pape HC, Zeichen J, Gosling T, Krettek C. Knee para-articular focal dome osteotomy. Orthopade 2004;33(2):170–7.
16. Paley D. Osteotomy concepts and frontal plane realignment. In: Herzenberg JE (ed) Principles of deformity correction, 1st edn. Springer, Berlin, 2002. p 112.
17. Paley D. Hardware and osteotomy considerations. In: Herzenberg JE (ed) Principles of deformity correction, 1st edn. Springer, Berlin, 2002. pp 300.
18. Sundaram NA, Hallett JP, Sullivan MF. Dome osteotomy of the tibia for osteoarthritis of the knee. J Bone Joint Surg (Br).1986;68(5):782–6.
19. Watanabe K, Tsuchiya H, Sakurakichi K, Matsubara H, Tomita K. Acute correction using focal dome osteotomy for deformity about knee joint. Arch Orthop Traum Surg.2008;128(12):1373–8.
20. Böstman O, Kiviluoto O, Nirhamo J. Comminuted displaced fractures of the patella. Injury. 1981;13(3):196–202.
21. Sharma L, Song J, Felson DT, Cahue S, Shamiyeh E, Dunlop DD. The role of knee alignment in disease progression and functional decline in knee osteoarthritis. JAMA 2001;286:188-95.
22. Gugenheim JJ, Brinker MR. Bone realignment with use of temporary external fixation for distal femoral valgus and varus deformities. J Bone Joint Surg. 2003;85-A(7):1229–37.
23. Heervarden RJV, Wymenga AB, Freiling D, Staubli AE. Indications-planning-surgical techniques using plate fixators. In: Lobenhoffer P, Heervarden RJV, Staubli AE, Jakob RP (eds) Osteotomies around the knee, 1st edn. Thieme Medical Publishers, New York, 2008. pp 147.
24. Seah MKT, Shafi R, Fragomen AT, Rozbruch SR. Distal femoral osteotomy: is internal fixation better than external? Clin Orthop Relat Res 2011;469(7):2003–11.
25. Wang JW, Hsu CC. Distal femoral varus osteotomy for osteoarthritis of the knee. Surgical technique. J Bone Joint Surg Am 2008;88(Suppl 1):100–8.
Published
2020-12-16
How to Cite
1.
Mohindra M, Gautam VK, Meena A, Gupta N, Desai J, Saikia S. Philos Plate For Fixation Of Supracondylar Dome Osteotomy. ojmpc [Internet]. 2020Dec.16 [cited 2021Jan.21];26(2):75-0. Available from: https://ojmpc.com/index.php/ojmpc/article/view/122
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Original Article