Case Presentation Osteotomy

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Presentation transcript:

Case Presentation Osteotomy S. Hofmann & O. Djahani General and Orthopaedic Hospital Stolzalpe

Case Severe Valgus W.K. 19 y Mentally retarded Not sportive Right Previous Femur# Left Valgus 38° developed during growth Limited walking distance & progressive instability

Gait pattern

Planning LDFA 75° MPTA 107° JLCA: 6° M-JL 89°

Case Challenge Planning What to offer patient Type of osteotomy Type of fixation LDFA 75° MPTA 107° JLCA: 6° M-JL 89°

Planning double level osteotomy

Planning Tibia Medial closed wedge Correction angle 20° Wedge 21mm Osteo length 62 mm

Planning Femur Lateral open wedge Correction angle 16° Wedge 18mm Valgus 4° Cave: JLCA ML/GL 89°

Outcome First medial closed tibia Then lateral open femur bone wedge for graft 6 weeks partial WB Radiographic conrol & progressive full WB Good function after 3 mo