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Year : 2020  |  Volume : 17  |  Issue : 3  |  Page : 247-252

Modified supracondylar chevron osteotomy for correction of genu valgum deformity in constrained resources

Central Institute of Orthopaedics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India

Correspondence Address:
Siddharth Gupta
Central Institute of Orthopaedics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi - 110 029
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/MJBL.MJBL_40_20

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Background: Various types of corrective osteotomies of the distal femur have been described in the literature for genu valgum deformity such as lateral opening wedge, medial closing wedge, dome osteotomy, wedgeless spike osteotomy, and wedgeless “V” osteotomy. Objectives: We aimed this study to evaluate the effectiveness of our modified supracondylar chevron osteotomy in correction of deformity. Materials and Methods: It was a prospective intervention study. Thirty young adults between the ages of 13–30 years were enrolled in the study. Modified chevron osteotomy was done and fixed with medial locking plate. Patients were evaluated at 1 year of follow-up. Results: A total of 30 patients included in the study underwent surgical correction of genu valgum deformity. The average blood loss during surgery was 187 ml (range, 150–260 ml). The mean duration of hospital stay was 4.5 days (range, 3–7 days). The mean time to union of osteotomy was 14.9 weeks (range, 12–17 weeks). The mean preoperative clinical tibiofemoral angle (TFA) was 23.4° (range, 18°–28°) that improved after surgery to a mean postoperative value of 5.8° (range, 4°–7°) which was statistically significant (P < 0.001). The mean preoperative radiological TFA was 23.5° (range, 19°–28°) that improved to a mean postoperative value of 5.7° (range, 4°–7°) and that was statistically significant (P < 0.001). Conclusion: Supracondylar chevron osteotomy and internal fixation with anatomically designed medial distal femur locking plate with the modified technique of using multiple 30-cm long solid 4.3-mm drill bits and using increasing width osteotome has the advantage of avoiding C-arm use and avoiding nibbling of the medial cortex. Keeping both limbs in the surgical field and replicating the clinical TFA with the help of sterile metal goniometer is a simple, safe, cost-effective procedure with a short learning curve that can be used for correction of genu valgum deformity in adolescent and young adult patients in constrained resource setup.

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