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[Correction of bowing in Paget's disease (author's transl)]
Abstract:
Thirteen tibiae and seven femora suffering from bowing due to Paget's disease have been streightened operatively. In the tibiae, the deformities were of metaphysial genu varum with bowing in the sagittal plane of an average of 30 degrees combined with some medial rotation. In the femora, the main curve was anterolateral with some medial rotation and coxa vara. Seventeen cases united uneventfully after osteotomy. In three cases, there were septic complications, union occurred after removal of the internal fixation. Bowing recurred in three cases. The recurrence appeared to be related to incomplete correction leading to persistent mechanical strain on bones affected by rapid bone turnover. Inadequate internal fixation may also be a factor. All other cases were functionally improved by correction. Oblique osteotomy is indicated for the correction of tibial deformity when there is moderate medial rotation. Transverse osteotomy with fixation by intramedullary nailing is indicated for correction of femoral deformities.