One-stage correction of angular deformities around the knee using internal fixation

Abstract

Background Deformity correction has been long performed using internal fixation. Since the introduction of external fixation in orthopedic practice, it has gained popularity in correcting severe deformities, and many orthopedic surgeons have resorted to external fixation to correct severe deformities. The authors asked if internal fixation can be safely used to correct significant deformities with marked mechanical axis deviation thus abolishing the notion that external fixation is the only available option to correct severe deformities. Patients and methods A single-center, prospective study was conducted at an academic center from October 2014 to December 2016. A total of 37 patients with lower limb deformities were included in the study. Overall, 13 patients were corrected using locked plates and 24 patients were corrected using intramedullary nails. The average follow-up was 13.5 months (10–18 months). Results The desired correction was achieved in all patients. Union was quicker with plates, but this could be attributed to the younger age of patients in that group. Discussion Many methods of fixation have been used to correct angular deformities around the knee. With patients’ satisfaction gaining utmost importance recently, surgeons have been revising their approach in managing various orthopedic conditions, and limb deformity is no exception. During the surgeons’ pursuit to achieve their patients’ maximum satisfaction without compromising the accuracy of correction or rigidity of fixation, two new techniques have emerged, namely, fixator-assisted plating and fixator-assisted nailing techniques, which represent a breakthrough in deformity correction, because they combine the advantages of internal and external fixation. The use of internal fixation usually yields higher patients’ satisfaction. Conclusion Internal fixation is a safe and effective treatment option for correcting significant deformities of the lower limb.