Double Level Osteotomy in an Overcorrected Distal Femoral Varisation Osteotomy: A Case Report

Area of Science:

• Orthopedic Surgery
• Pediatric Orthopedics
• Biomechanical Analysis

Background:

• Idiopathic genu valgum is a common condition often treated with corrective osteotomies.
• Distal femur osteotomies are frequently employed to correct valgus deformities.
• Long-term outcomes and potential for deformity progression require ongoing investigation.

Observation:

• A patient initially treated for idiopathic genu valgum with bilateral distal femur osteotomies developed recurrent varus deformity at age 30.
• Preoperative imaging revealed a bifocal deformity involving both the distal femur and proximal tibia.
• The patient presented with significant knee pain attributed to the varus deformity.

Findings:

• A bifocal deformity necessitates a 2-level osteotomy for effective correction.
• Single-stage corrective osteotomies at both the distal femur and proximal tibia were performed.
• Accurate identification of all deformity sites is crucial for successful surgical outcomes.

Implications:

• Thorough preoperative assessment is vital for identifying multifocal bone deformities.
• Failure to address bifocal pathology can lead to suboptimal correction and joint line obliquity.
• This case underscores the importance of comprehensive surgical planning in complex pediatric orthopedic cases.