A Novel Technique of Stabilization of Supracondylar Femoral Dome Osteotomy with Proximal Humeral Locking Plate for Surgical Management of Genu Valgum Deformity

Abstract

Background: Genu valgum is a common deformity in the developing world. When the patient presents after a second growth spurt, corrective surgery remains the only treatment option. Different types of osteotomies and fixation methods have been described in the literature, but the choice of the method remains debatable. We evaluated the outcome of the proximal humeral locking plate used for stabilization of supracondylar femoral dome osteotomy (DO). Methods: In this prospective study, we performed 39 osteotomies for genu valgum deformity on 24 patients who satisfied inclusion criteria (15 bilateral and 9 unilateral) between May 2015 and May 2017. The mean age was 13 years (11–20), 16 were male and 8 were female patients. All patients underwent supracondylar femoral DO and stabilization with the proximal humeral locking plate. Informed consent was obtained from all patients. All patients were evaluated preoperatively and postoperatively by using the Bostman knee score, intermalleolar distance (IMD), tibiofemoral angle (TFA), and lateral distal-femoral angle (LDFA). Patients with a minimum follow-up of 2 years were included in the study. Results: The preoperative LDFA was 73.4 ± 2.1 which improved to 87.2 ± 0.6 postoperatively while clinical and radiological TFA improved from 19.7 ± 21 and 21.4 ± 2.1 to 7.3 ± 0.8 and 8.6 ± 0.8, respectively. The mean Bostman score improved significantly. Two patients (2 limbs) had a good score (20–27), while the rest had an excellent score (28–30). IMD, TFA, and LDFA also improved statistically significantly (P < 0.001). All the patients were satisfied with the cosmetic correction. There were no implant failures, re-operations, and any loss of correction. Conclusion: This novel technique of stabilizing supracondylar femoral DO with the proximal humeral locking plate is cost-effective and has encouraging early results.