Lower limb coronal malalignment correction by percutaneous osteotomy and schanz screws fixation

Area of Science:

• Orthopedic Surgery
• Pediatric Orthopedics
• Pediatric Deformity Correction

Background:

• Pediatric knee deformities, such as genu varum, are common and often treated with corrective osteotomy.
• Traditional osteotomy methods can be invasive, prompting research into less invasive alternatives.

Purpose of the Study:

• To evaluate the safety and efficacy of percutaneous low-energy osteotomy and casting with Shanz screws fixation.
• To assess this technique in treating genu varum in children aged 7 years or younger.

Main Methods:

• A prospective, nonrandomized case series included 38 patients (60 limbs) treated with percutaneous low-energy osteotomy and casting with Shanz screws fixation.
• Follow-up ranged from 2-5 years, with clinical and radiological outcomes assessed using standing scanograms.
• Measurements included tibiofemoral angles, mechanical axis, and complication rates.

Main Results:

• Statistically significant improvements were observed in radiographic parameters, including tibiofemoral angle and mechanical axis deviation (MAD).
• Clinically, all cases achieved complete correction. One patient experienced over-correction (two limbs), which was not statistically significant.
• A single complication of pin tract infection in Shanz screws fixation was noted in one patient.

Conclusions:

• Percutaneous low-energy osteotomy and casting with Shanz screws fixation is a simple, safe, and effective treatment for pediatric knee deformities in children 7 years and younger.
• This minimally invasive technique offers a viable alternative for correcting genu varum and other pathological knee deformities in the pediatric population.