Multiplanar correction of proximal tibial recurvatum deformity with tibial osteotomy and computer assisted fixator

Abstract

BackgroundSeveral treatment modalities including open wedge osteotomies and Ilizarov reconstruction have been described for treatment of Proximal tibial recurvatum (PTR). However, the literature lacks information regarding the multiplanar correction of PTR using the computer assisted hexapod external fixator. The aim of the study is to present the results of PTR treatment with a computer assisted fixator systems. MethodsThere were three female and three male patients (10 lower extremities) with a mean age of 20.6 years (7.3 to 25.2y) in the study group. The angle of genu recurvatum (aGR), the tibial plateau tilt angle (aTP), the mechanical posterior proximal tibial angle (mPPTA) and sagittal mechanical axis deviation (MADs) was measured for the sagittal plane assessment. ResultsPreoperative sagittal assessment showed that the mean aGR was 28.9°±6.8°, mean aTP was 64.5°±10.2° and mean mPPTA was mPPTA was 114.1° ±10.3°. At the final follow-up there was a significant correction (p < 0.05 for aGR, aTP and mPPTA). Mean MADs was improved from 66.1 ± 14.2 mm to 16.6 ± 5.1 mm (p:0.005). Mean A:B ratio was 0.92 ± 0.13 preoperatively and 0.89 ± 0.14 postoperatively (p:0.37). Nine out of 10 knees had valgus deformity and mean preoperative tibiofemoral anatomic angle (TFA) was improved from 10.8°±3.7° valgus to 6.5°±1.7° valgus. ConclusionThe treatment of PTR deformity with a computer-assisted hexapod external fixator is safe and effective. It provides multiplanar correction of the deformity with a high precision and the patellar alignment remains stable during the correction.