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[Femoral varus osteotomy combined with interlocking nailing for treatment of genu valgum].

OBJECTIVE: To assess the effect of medial distal femoral osteotomy combined with interlocking nailing on the treatment of knee osteoarthritis with valgus deformity. METHODS: From May 1996 to August 2000, 16 patients with knee osteoarthritis accompanied by valgus deformity were treated by medial wedged distal femoral osteotomy combined with interlocking nailing. Full-length radiographs were taken before operation and 8 weeks and 2 years after operation. The parameters, including the femorotibial angle, the tibial angle, the femoral angle, the femoral condyle-tibial plateau angle, and the lateral joint space, were measured by these radiographs. The function of knee was evaluated by the 100-point rating scale standard of knee. RESULTS: The mean postoperative score was significantly improved from 50.4 +/- 15.9 points to 78.5 +/- 12.9 points 2 years after the surgery. The lateral joint space was increased from 2.1 +/- 1.8 mm to 4.7 +/- 1.7 mm and the femoral condyle-tibial angle decreased from 5.6 +/- 2.9 degrees to 1.6 +/- 3.4 degrees. There were complications in 2 cases: 1 case of delayed union and 1 case of superficial wound infection. CONCLUSION: Medial distal femoral osteotomy combined with interlocking nailing proves to be an effective approach to treat knee osteoarthritis with valgus deformity.

Adult↗

[Management of varus knee arthrosis by high tibial osteotomy].

Authors made a follow-up of 69 varsus knee arthrosis treated with high tibial osteotomy. Beside the general results the effect of the severeness of the arthrosis before the correction and that of the gain of the axial correction on the result were also investigated. 56 (81 per cent) of the reexamined patient reported excellent or good results. The ratio of the successful operations was even higher in cases in which the femorotibial axis was corrected to physiological valgus (95 per cent). The best prognosis of the osteotomy is in the early stage of arthrosis (Ahlbäck 0-II). In cases of the more advanced process the ratio of the unsuccessful cases increases. In consequence it is stated that the best results can be expected after osteotomies performed in the early stage and leading to the physiological femorotibial valgus position.

Arthritis, Rheumatoid↗

Running limb varus.

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Foot Deformities↗

[Instrumental correction of valgo-varus and torsion deformities of the proximal segment of the femur in children].

Apparatus correction of deformations of proximal segment of femur becomes one of the most effective method of treatment of hip joint diseases in children. The authors propose new arrangements of Ilizarov's apparatus to treat the most common diseases of locomotor apparatus: thigh subluxation, aseptic necrosis of the head of femur and coxa vara. The tactics of Ilizarov's apparatus application, its arrangements and indications for its utilization are based on the results of treatment of 40 patients with the above-mentioned diseases. There are presented the apparatus application outlines and clinical examples of the treatment methods realization.

Acetabulum↗

Varus rotational femoral osteotomies in adults with hip dysplasia.

Fifty-six hips in 48 consecutive patients operated on for congenital dysplasia of the hip during the years 1971 through 1986 were evaluated for an average follow-up period of nine years (range, two-21 years). Twenty-three percent of the patients were treated with revision to total hip arthroplasty by the time of follow-up examination. The average time before revision was 8.6 years. All but three of the remaining hips were rated good or excellent (72%). These patients tended to have minimal or no preoperative degenerative joint disease. Complications included one subtrochanteric fracture, two cases of loss of fixation, and one superficial wound infection. The authors conclude that the operation provides predictable, high-quality results in those patients with minimal or no degenerative changes preoperatively. In those patients with mild or moderate degenerative changes, it may forestall the onset of severe symptoms by several years.

Adolescent↗

Cannulated blade plate for proximal femoral varus osteotomy.

Fixation of the osteotomy site in the proximal femur is technically demanding. A new system, which includes cannulated chisels and a cannulated one-piece plate that can be inserted over a guide wire, is suggested. The new system simplifies the procedure and provides stable fixation.

Bone Plates↗

[Role of parainfluenza varuses in etiology of acute respiratory infections in children (serological diagnosis)].

Serologic investigations carried out in 254 children admitted to a Clinic for Children for respiratory diseases, established a diagnosis of infection with parainfluenza virus in 19.2% of cases. The predominant age-group affected was 7--12 months and 0--6 months; the causative agent in most cases was parainfluenza type 3, followed by type 2 and then type 1. The role of parainfluenza viruses in the aetiology of laryngotracheobronchiectasis was confirmed, as well as their participation in the aetiology of pneumonia in infants. The results also showed the wide circulation of parainfluenza viruses in children and their outstanding contribution to respiratory diseases among hospitalized children within a period of four years.

Antibodies, Viral↗

[Accuracy in high tibial osteotomy in varus gonarthrosis].

We have verified our technical accuracy in a series of 72 high tibial osteotomies for medical gonarthrosis, which were operated following Install's technique. An acceptable alignment (6 degrees-15 degrees valgus) was achieved in 83% of the cases; a loss of correction during the healing phase was detected in 10% of the knees. We have modified some details of the previously employed technique in order to improve accuracy. The leg alignment is determined on 30 x 90 cm standing radiographs, defining the mechanical axes; we aim at 4 degrees of valgus. A guide is employed to determine the width of the wedge of bone to be removed. The osteotomy is fixed by means of two screws and wire; the fixation obtained is stable enough to allow early weigh bearing and range of motion. With these modifications we have been able to improve technical accuracy and we have rendered the postoperative course more acceptable to the patients.

Adult↗