Anterior open wedge osteotomy of the distal femur

Abstract

To treat instability caused by agenu recurvatum using ventral open wedge osteotomy of the distal femur. Knee instability caused by Genu recurvatum with femoral extension deformity. Inadequate blood flow to the lower extremity, soft tissue issues, obesity, osteoporosis. Through aprimary medial approach to the distal femur, aventral open wedge osteotomy is performed using chisel bunch formation and arthrodesis spreader. For symmetrical expansion, another lateral approach at the distal femur and insertion of another arthrodesis spreader is performed. Osteosynthesis was performed with an angle stable plate from the medial side and with additional stabilization using a4-hole angle stable plate from the lateral side. The osteotomy gap was filled with abone graft wedge. Partial weight-bearing of 20 kg was allowed for 6weeks with passive exercise and lymphatic drainage. Ahard frame orthosis for immobilization at 0-10-90° was fitted for 6weeks. Radiographic controls were performed at 6weeks, 3months, and 1year. After the last radiographic control, hardware was removed. There are no reports in the current literature regarding the effect of achange in the sagittal plane at the distal femur on alignment, stability, and biomechanics of the knee. This case report shows that genu recurvatum with physiological posterior tibial slope can be successfully treated with anterior femoral flexion osteotomy. Hyperextension was completely eliminated at the follow-up examination after hardware removal after 12months.