Dual Femoral and Tibial Osteotomies for Large Varus and Valgus Deformities

The aim of this study is to evaluate the outcomes of acute correction of large varus and valgus deformities with simultaneous distal femoral and tibial osteotomies. Acute correction of large coronal plane deformities is complex and if done incorrectly, can lead to problems like non-union, soft tissue problems, and joint line obliquity.

Radiographic, clinical, and patient-reported outcomes are analysed through a retrospective series of 21 extremities in 18 consecutive patients with coexisting femoral and tibial deformities who underwent concurrent distal femoral and proximal tibial osteotomies with acute coronal plane correction and internal fixation.

The mean mechanical axis deviation (MAD) correction was 56 mm for varus deformities (n = 13) and 45 mm for valgus deformities (n = 8) with an overall mean correction of the femoral tibial angle of 15° per extremity. The accuracy of correction was 92.9% compared to the goal MAD. Two patients had peri-incisional cellulitis that resolved with antibiotics. There was no incidence of non-union, deep vein thrombosis, compartment syndrome, deep infection, or peripheral nerve palsy. Patient-reported outcome scores had clinically meaningful improvements in pain, function, and mental health.

Acute correction of large coronal plane deformities can be accurately and safely performed with simultaneous distal femoral and proximal tibial osteotomies with internal fixation.

This study highlights a safe method to accurately correct large coronal plane deformities in the lower extremity.

Wallace SJ, Jaime MK, Fragomen AT, et al. Dual Femoral and Tibial Osteotomies for Large Varus and Valgus Deformities. Strategies Trauma Limb Reconstr 2024;19(3):135-140.