[Simple supporting device for genu valgum, genu varum and the unstable knee joint].
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Humans↗
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Results for “Genu Valgum”
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Effects of simulated genu valgum and genu varum on ground reaction forces and subtalar joint function during gait.
The mechanical effects of genu valgum and varum deformities on the subtalar joint were investigated. First, a theoretical model of the forces within the foot and lower extremity during relaxed bipedal stance was developed predicting the rotational effect on the subtalar joint due to genu valgum and varum deformities. Second, a kinetic gait study was performed involving 15 subjects who walked with simulated genu valgum and genu varum over a force plate and a plantar pressure mat to determine the changes in the ground reaction force vector within the frontal plane and the changes in the center-of-pressure location on the plantar foot. These results predicted that a genu varum deformity would tend to cause a subtalar pronation moment to increase or a supination moment to decrease during the contact and propulsion phases of walking. With genu valgum, it was determined that during the contact phase a subtalar pronation moment would increase, whereas in the early propulsive phase, a subtalar supination moment would increase or a pronation moment would decrease. However, the current inability to track the spatial position of the subtalar joint axis makes it difficult to determine the absolute direction and magnitudes of the subtalar joint moments.
Adolescent↗
[Treatment of genu valgum and genu varum with supracondylar wedge osteotomy of the femur].
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Adolescent↗
[On the statics, etiology and treatment of genu valgum and genu varum].
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Biomechanical Phenomena↗
Physeal stapling for idiopathic genu valgum.
Adolescent idiopathic genu valgum may cause anterior knee pain, patellofemoral instability, circumduction gait, and difficulty running. The purpose of this study was to evaluate and discuss what we consider to be an ideal treatment protocol using hemiphyseal stapling. We reviewed 76 patients (152 knees) who underwent hemiphyseal stapling for idiopathic adolescent genu valgum and were followed up to maturity. Clinical evaluation included assessment of gait, limb length, alignment, and patellofemoral stability. Radiographic evaluation included measurement of the distal femoral angle (DFA), the anatomic femoral tibial angle (FTA), and the mechanical axis (MA) before stapling, at the time of staple removal, and at skeletal maturity. After stapling, we noted improvement in gait, clinical symptoms, and all radiographic parameters. Our conclusion is that adolescent genu valgum may cause significant symptoms including anterior knee pain and gait problems. Hemiphyseal stapling addresses the anatomic malalignment, alleviating symptoms while offering a high degree of patient satisfaction. It is safe and effective, with no premature physeal closures noted in our series. The procedure, which is well tolerated, obviates the need for corrective femoral osteotomies.
Adolescent↗
[Percutaneous epiphysiodesis in the treatment of adolescent genu valgum].
UNLABELLED: Persistent genu valgum in adolescent induce abnormal gait and functional disturbances. Surgical correction should prevent secondary osteoarthritis. MATERIAL AND METHODS: Twenty three percutaneous epiphysiodesis in 12 children are reviewed at the end of growth. The surgical technique and the X-ray evaluation and timing calculation of epiphysiodesis according to Bowen are described. RESULTS: The supine intermalleolar distance is reduced from 11.8 cm to 2.8 cm. The femoro-tibial angle is reduced from 12.9 degrees to 7.9 degrees and distance between mechanical axis and center of knee from 25.3 mm to 8.6 mm. These results are very good, without any complications. DISCUSSION: Percutaneous epiphysiodesis is really a mini-invasive and cost effective method for treatment of genu valgum. The results are at least as good as in Blount stapling without any complication or second surgery for hardware removal. The timing of epiphysiodesis remain a difficult problem and the physician should be very cautious in determining the good time for surgery. CONCLUSION: Percutaneous epiphysiodesis is today the treatment of choice for genu valgum. This method is non invasive and cost effective.
Adolescent↗
Partial epiphysiodesis to address genu varum or genu valgum.
Two groups of children with excessive genu valgum or genu varum were treated with a partial epiphysiodesis. In group I (16 extremities) a predictive chart was used to determine the appropriate bone age to perform the partial epiphysiodesis, and in group II (15 extremities) the age for the procedure was estimated. The partial epiphysiodesis was performed by either an open or a percutaneous technique. In group I the correction of the genu valgum and genu varum followed the predicted course, whereas group II resulted in a 9.1 degree error. Genu valgum and genu varum in children with adequate remaining growth can be corrected using a predictive growth chart to determine the appropriate bone age for the procedure.
Adolescent↗
Genu varum and genu valgum in children.
Genu varum and genu valgum are often normal developmental changes in knee alignment that occur in a young child. Measuring the child's height and understanding normal development is the key to determining which children need further evaluation for a possible skeletal or metabolic bone dysplasia.
Child, Preschool↗
Medial physeal stapling for primary and secondary genu valgum in late childhood and adolescence.
We report the results of medial physeal stapling in 16 knees with primary genu valgum and 27 with secondary genu valgum. In the primary group, stapling was undertaken at a mean chronological age of 12 years in girls and 13 years in boys. The medial femoral physis was stapled in ten knees and the medial femoral and tibial physes in six knees. At skeletal maturity, all patients had excellent or good leg alignment. Secondary genu valgum is due to skeletal dysplasia, haematological or endocrine disorders, or to juvenile chronic arthritis. Stapling was at a mean chronological age of 11 years in girls and 14 years in boys. The medial femoral physis was stapled in 13 knees, the medial tibial physis in three and both in 11 knees. At skeletal maturity, 85% had excellent or good leg alignment, and correction had occurred within one year. Two of the poor results were due to staple extrusion from osteoporotic bone, and two to overcorrection. Rebound growth was minimal and unpredictable after the removal of staples. Medial physeal stapling is a suitable method of treatment for both primary and secondary genu valgum in late childhood and in adolescence. At least one year of knee growth is required to achieve correction, and care is needed to avoid overcorrection of the secondary genu valgum.
Adolescent↗
Genu valgum in children with coxa vara resulting from hip disease.
Three patients with chronic hip disease and progressive coxa vera deformity also had an unrecognized compensatory ipsilateral genu valgum until the primary hip deformity had been corrected operatively. This unrecognized genu valgum may become subtly worse in a growing child because of lateralization of the mechanical axis of the lower extremity with respect to the knee joint. Operative correction of coxa vara acutely moves the mechanical axis farther laterally, causing the occult genu valgum to become clinically apparent. The genu valgum may subtly worsen over time in a growing child because of lateralization of the lower extremity mechanical axis with respect to the knee joint, with the resulting abnormal Hueter-Volkmann forces across the physis causing progressive genu valgum. Recognition of occult genu valgum before correcting coxa vara in children allows the surgeon the better to advise the family about the need for possible subsequent operations on the knee.
Adolescent↗
47Ca turnover in endemic fluorosis and endemic genu valgum.
1. Calcium turnover was determined after intravenous injection of radioactive 47Ca in patients with fluorosis and endemic genu valgum and in age-matched controls. Total Ca turnover in the body, loss of Ca from the body in urine, faeces and sweat (external turnover) and bone mineralization rate were calculated from whole-body retention of 47Ca and specific activity of 47Ca in serum. 2. Total Ca turnover was significantly higher in younger subjects than in older subjects. 3. Total Ca turnover was significantly higher in patients with fluorosis and in those with endemic genu valgum than in age-matched controls, but the external turnover of Ca was lower in both groups of patients than in controls. 4. Bone mineralization rate was significantly higher in patients with fluorosis and in those with genu valgum as compared to age-matched controls. 5. Total body Ca turnover and bone mineralization rates were significantly higher in patients with endemic genu valgum than in those with fluorosis. The differences persited even after adjusting for differences in age between patients with fluorosis and those with genu valgum.
Adolescent↗
Genu Valgum in Children: Diagnostic and Therapeutic Alternatives.
Genu valgum is a common orthopaedic problem in children. The vast majority of cases are physiologic variants, which resolve normally. However, there are pathologic entities due to both focal and systemic processes in which the deformity often progresses and usually requires treatment. Differentiating between the two forms is facilitated by a thorough understanding of the natural history of the development of the tibiofemoral angle in children. In this review, an approach to the evaluation and diagnosis of genu valgum is presented, and therapeutic alternatives are discussed.
Journal Article↗
[Distal femoral varus osteotomy for symptomatic genu valgum: long-term results and review of the literature].
PURPOSE OF THE STUDY: We report our experience with eleven patients treated for disabling genu valgum from 1979 to 1994. MATERIAL AND METHODS: Genu valgum resulted from femoral deformation in all patients. Ten had a congenital condition and one a post-traumatic knee. IKS scores were used for the clinical evaluation. The lateral femorotibial joint space and the lateral femoral angle (LFA) were measured on plain films. Goniometry was used to measure the axis of the loaded lower limb. All patients underwent osteotomy of the distal femur for varisation and plate fixation. One patient required revision for a unicompartment lateral prosthesis subsequent to fracture of the homolateral lateral tibial plateau. Mean follow-up was 10.5 years (3.5-21.5). RESULTS: There were no cases of nonunion. Four patients had a good or excellent knee score. Eight patients had a good or excellent function score. Osteoarthritis worsened in two patients. The mean LFA increased from 72.5 degrees preoperatively to 83.5 degrees postoperatively and a last follow-up. Mean genu valgum was 13 degrees preoperatively and 2 degrees at last follow-up. All patients except one were satisfied or very satisfied. Insufficient correction appeared to be the main complaint. DISCUSSION: These results and results reported in the literature demonstrate that distal femoral osteotomy for disabling genu valgum is an effective treatment if the correction is complete and osteosynthesis effective, providing long lasting results when femoral deformation is involved and osteoarthritis limited.
Adult↗
Genu valgum deformity in Hurler syndrome after hematopoietic stem cell transplantation: correction by surgical intervention.
Hematopoietic stem cell transplantation has increased the survival of patients with Hurler syndrome. Genu valgum occurs frequently in untransplanted patients and has been noted in 52% of our patients after stable engraftment. No deformities spontaneously corrected. We describe the orthopaedic management of genu valgum in Hurler syndrome. Medial epiphyseal stapling predictably affects angular deformity in these patients. Recurrence of deformities either after staple dislodgement or surgical removal can occur, and repeated stapling may be required. Surgical epiphyseal stapling has a role in the management of genu valgum in successfully engrafted Hurler patients. We discuss the relationship of this skeletal deformity to other skeletal deformities and alternative therapies for genu valgum.
Adolescent↗
[Schnyder's crystalline dystrophy. II. Association with genu valgum].
The present study describes a family in which Schnyder's crystalline stromal dystrophy coexisted with genu valgum. One member, a woman, exhibited only the corneal dystrophy. She underwent a bilateral corneal graft and the buttons studied by light and electron microscopy were described in another report. Her daughter exhibited only genu valgum and her son had both disorders. It is to our knowledge the fourth report on the combination of Schnyder's dystrophy and genu valgum in the same family. The significance of this association and other associations like hyperlipoproteinaemia and xanthelasma are discussed.
Abnormalities, Multiple↗
Hereditary pubertal genu valgum in Iran.
Two male offspring of a healthy father in Galaz, a remote village in Northwest Iran, were noted to show severe asymmetric genu valgum, with 57 and 82 degrees angulation and dysplasia of the lateral femoral condyle, together with adaptive biomechanical changes of the ankle alignment. Three of the five male offspring of a second marriage who have reached puberty also show variable degrees of genu valgum, increasing with growth. The intermalleolar distance in the affected sons aged 16, 15, and 12 measured 21, 16, and 14 cm, respectively, before epiphysodesis. None of the six female offspring from either marriage, and neither of the two sons under the age of 11 from the second marriage show any skeletal deformity. All members of the family are otherwise mentally and physically normal. It is possible that this genu valgum may be due to a new autosomal dominant mutation which probably occurred in the gonads of the unaffected father. The condition shows an onset age of 11 and appears to have a sex-limited expression.
Adolescent↗
Circulating levels of immunoreactive parathyroid hormone in endemic genu valgum.
Circulating levels of immunoreactive parathyroid hormone (PTH) were estimated in fifteen normal subjects and twenty-five subjects suffering from the skeletal fluorosis, ten of whom had associated endemic genu valgum. Levels of PTH were high in all the subjects with fluorosis as compared to normals, but among fluorosis subjects, those who had endemic genu valgum had values strikingly higher than those without. It is suggested that secondary hyperparathyroidism may have a significant role to play in the pathogenesis of osteoporosis seen in patients with endemic genu valgum.
Adolescent↗
[Presence of genu valgum in obese children: cause or effect?].
BACKGROUND: Changes in body configuration that may affect the physical activity may play a role in the caloric consumption and led to the development of obesity. OBJECTIVES: To determine the presence of genu valgum, an alteration that may decrease physical activity and caloric expenditure, in overweight children. METHODS: Thirty-five overweight children without any endocrinological alterations that could lead to obesity were studied. Twenty-nine non-overweight children of a similar age were studied as a control group. In all children weight, height, and body mass index (BMI) were studied, and intermalleolar distance was used to measure the degree of genu valgum. The differences between groups were studied using ANOVA and the correlation between variables was determined using Pearson's correlation. RESULTS: BMI was higher in overweight children than in the control group. Intermalleolar distance was greater in overweight children than in the non-overweight group (11.0 0.6 vs 2.90 0.43; p < 0.001). A positive correlation between the intermalleolar distance and the BMI was observed in the overweight group (p < 0.009). Fifty percent of the overweight children showed an intermalleolar distance of more than 10 cm, a value considered abnormal. CONCLUSIONS: The incidence of genu valgum is much higher in overweight children than in non-overweight children of the same age. This alteration may lead to decreased physical activity and lead to obesity.
Child↗