Supracondylar “V” osteotomy for postrachitic genu valgum in children: A case series

Abstract

Objectives: Among the various options available for correction of genu valgum deformities, supracondylar “V” osteotomy is a sparsely used technique. We used the technique for correction of postrachitic deformity in late childhood and adolescence and report the outcome achieved. Patients and Methods: Our operative criteria were age range between 10 and 12 years, a normal metabolic profile, and genu valgum deformity with a standing radiological tibiofemoral angle ≥15°. Patients who had gross collateral ligament instability, any restriction of knee range of motion, genu recurvatum, predominant tibial deformity component, epiphyseal irregularities, active metabolic disease were excluded from the study. Correction was undertaken using “V” osteotomy technique described by Aglietti et al. and was stabilized by two Kirschner wires. Functional outcome was assessed using Bostman et al. score. Results: Seventeen limbs in nine patients with a mean age of 11 years were operated. All the genu valgum deformities were postrachitic but with healed status. Mean follow-up of patients was 24.8 months. Preoperative radiological tibio-femoral angle had a mean value of 20.2° which improved to a mean of 3.05° postoperatively. Knee score was excellent in 88.8%, good in 11.1%. All patients recovered full range of knee motion within 6 weeks after removal of the cast. Two main complications were deep infection and partial slippage of lower femoral physis in one case each. Conclusions: Supracondylar “V” osteotomy is a viable option for the correction of postrachitic genu valgum deformity in older children and adolescents with limited residual physeal growth not amenable to growth modulation procedures.