Congenital Varus Deformity Research Articles

Closing wedge ostectomy with transfixation pin-cast stabilization for correction of angular limb deformities of the metatarsophalangeal region in four cattle.

4 calves were evaluated because of lameness and an angular limb deformity of the metatarsophalangeal region. 3 calves (ages, 5 days, 10 days, and 1 month) had a congenital varus deformity of the metatarsophalangeal region characterized by medial subluxation of the first phalanx of digits 3 and 4 at the metatarsophalangeal joints. A 6-month-old heifer had a valgus deformity of the metatarsophalangeal region secondary to a malunion of a Salter-Harris type II fracture. The degree of deformity angulation ranged from 16° to 54° for the 4 patients. A closing wedge ostectomy with transfixation pin-cast application was performed on the affected limb of all 4 patients. The ostectomy healed with only minor complications (disuse osteopenia distal to the transfixation pins [n = 4] and cast sores [1]) that were easily resolved with no long-term adverse effects. Duration of follow-up for the 4 patients ranged from 6 to 17 months, and the owners reported satisfactory ambulation with no (n = 2) or only mild (2) residual lameness in the affected limb. Results suggested that a closing wedge ostectomy with transfixation pin-cast stabilization is an alternative for management of angular limb deformities of the metatarsophalangeal region in cattle. Such treatment improved the quality of life for all 4 patients. However, 2 of the 4 patients had congenital deformities confirmed to be heritable. There are ethical concerns associated with treating animals with heritable disorders, and exhibition and breeding of such animals should be avoided.

Peculiarities of Bone Regenerate Structural Condition in Patients with Achondroplasia and Congenital Varus Deformity

Peculiarities of osteogenesis course in patients with achondroplasia at crus lengthening and in patients with congenital varus deformity in the process of correction were studied using US methods. Qualitative and quantitative US criteria that characterized normal, high and low reparative osteogenesis activity were presented. It was established that distraction regenerate with low level of osteogenesis was characterized by delayed organotypical reconstruction and disturbance of microcirculatory bed formation. The necessity of dynamic US examination during the whole period of treatment was shown.

Accuracy of high tibial osteotomy: comparison between open- and closed-wedge technique

High tibial osteotomy is an established technique for the treatment of varus malaligned knees. This study analyses the difference between the amount of correction in the preoperative planning and the postoperative result. Furthermore, it compares the difference of the accuracy between open-wedge osteotomy and closed-wedge osteotomy. About 61 patients were either treated with open-wedge or closed-wedge high tibial osteotomy. Preoperative planning and postoperative analysis were performed with a special planning software. The influence of operative technique, aetiology, age, number of previous surgeries, amount of correction and accuracy of the correction compared to the preoperative planning were analysed. The overall postoperative mechanical axis differed form preoperative planning by 2.1°±1.7°. The accuracy in the open-wedge group (1.7°±1.6°) was significantly higher than in the closed-wedge group (2.6°±1.8°; P=0.038). In patients with congenital varus deformity, the accuracy of the correction was significantly higher than in patients with post-traumatic deformity. The authors recommend open-wedge technique in combination with fixed-angle plates for high tibial osteotomy.