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Corrective osteotomy for deformity in Paget disease.

Javad Parvizi1, Mark A Frankle, Robert D Tiegs

  • 1Department of Orthopedics and Endocrinology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.

The Journal of Bone and Joint Surgery. American Volume
|April 4, 2003
PubMed
Summary

Corrective osteotomy effectively treats severe Paget disease deformities, improving function and appearance. While complications occurred, especially with certain fixation methods, most osteotomies healed successfully.

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Area of Science:

  • Orthopedic surgery
  • Paget's disease of bone
  • Skeletal deformities

Background:

  • Severe long-bone deformities from Paget disease cause pain and functional limitations.
  • Corrective osteotomy is a potential treatment, but its outcomes in Paget disease are not well-documented.

Purpose of the Study:

  • To evaluate the outcomes of corrective osteotomy for long-bone deformities in patients with Paget disease.
  • To identify factors influencing healing and complications.

Main Methods:

  • Retrospective review of 25 corrective osteotomies in 22 patients (1975-1995).
  • Indications included pain, stress fractures, and functional limitation.
  • Various osteotomy and fixation techniques were employed.

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Main Results:

  • Twenty-three of 25 osteotomies achieved union, averaging six months.
  • Metaphyseal osteotomies with plate fixation healed faster than diaphyseal osteotomies.
  • Patient satisfaction was generally good, though complications like infection and nerve palsy occurred.

Conclusions:

  • Corrective osteotomy is a viable, albeit challenging, treatment for severe Paget disease deformities.
  • Intramedullary nailing and external fixation were associated with higher complication rates.
  • Diaphyseal osteotomies showed prolonged healing times.