Document Detail

Recurrence of axial malalignment after surgical correction in congenital femoral deficiency and fibular hemimelia.
MedLine Citation:
PMID:  21537976     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Recurrent genu valgum deformity complicates treatment of congenital femoral deficiencies (CFD) and fibular hemimelia (FH). We analysed factors influencing recurrence.
METHODS: Patients who underwent limb lengthening or deformity correction for CFD and/or FH were reviewed. Radiographs after surgery and after a minimum of a further six months were analysed. Change in parameters of mechanical axis deviation per month (∆ MAD/month) and of angle per month were calculated. These parameters were tested against cofactors patient age, baseline MAD, type of CFD and FH, severity of ball-and-socket joints, ankle-joint stiffness, absence of cruciate ligaments and resection of the fibular anlage.
RESULTS: Recurrent valgus deformity was found in 23 of the 42 limbs included with a mean change of MAD of 23.4 mm (5-60 mm). There was no significant difference between patients with ∆ MAD/month <0.5 mm versus >1 mm regarding MAD in the first radiograph and patient age. CFD cases Pappas types VII and VIII showed a ∆ MAD/month of 1.6 mm, whereas milder cases of Pappas IX showed a ∆ MAD/month of 0.8. Mild FH (type Ia) showed a mean ∆ MAD/month of 0.39 mm, whereas mean ∆ MAD/month for FH type Ib/II was 0.72 mm. In FH type II cases, mean ∆ MAD/month was 0.79 mm after resection of the fibular anlage compared with 1.98 mm in those without resection.
CONCLUSIONS: Recurrence in FH and CFD was not dependent on patient age but partly on FH and CFD type. Limbs with more severe ball-and-socket knee joints showed more recurrence. Overcorrection depending deformity type should be performed.
Christof Radler; Giorgio Antonietti; Rudolf Ganger; Franz Grill
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Publication Detail:
Type:  Journal Article     Date:  2011-05-03
Journal Detail:
Title:  International orthopaedics     Volume:  35     ISSN:  1432-5195     ISO Abbreviation:  Int Orthop     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-10-17     Completed Date:  2012-02-07     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  7705431     Medline TA:  Int Orthop     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1683-8     Citation Subset:  IM    
Department of Pediatric Orthopaedics, Orthopaedic Hospital Speising, Speisinger Strasse 109, 1130, Vienna, Austria.
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MeSH Terms
Bone Lengthening / adverse effects,  methods*
Child, Preschool
Coxa Valga / etiology,  pathology*
Ectromelia / complications,  pathology*,  surgery
Femur / abnormalities*,  surgery
Fibula / abnormalities*,  surgery
Lower Extremity Deformities, Congenital / complications,  pathology*,  surgery
Postoperative Complications
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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