Abstract

The treatment of angular malalignment includes restoration of normal mechanical axis alignment and joint orientation.the supracondylar wedgeless distal femoral ‘V’ osteotomy, as a treatment modality, is sparsely explored in the literature.

this study was conducted at a tertiary level teaching referral hospital from october 2010 to September 2012. Forty six lower limbs (in 30 patients) were operated with a wedgeless ‘V’ osteotomy that was fixed with a buttress ‘L’ plate. the pre-operative deformity, post-operative correction and knee range of movement were noted. Mobilisation was started at 3 weeks after surgery and full weight-bearing was allowed at 3 months. the knee score by Bostman et al. was used for functional outcome.

The mean age of the patients in our study was 16.9 years (range : 15 years to 23 years). the patients were followed up for a mean period of 19.8 months (range, 15 months to 29 months). the mean radiological tibio femoral angle was 22.2o (range, 16o to 29o) before surgery, that improved to a mean postoperative value of 5.1o (range, 0o to 10o) (p < 0.001). the mean pre operative lateral distal femoral angle was 79.23o that improved to a mean value of 89.13o after surgery (p < 0.001). the mean mechanical axis deviation was 19.56 mm before surgery that improved to a mean postoperative value of 3.7 mm (p < 0.001). All patients reached a correction of the deformity and 44 cases out of a total of 46 had an excellent functional outcome, 2 patients had a good functional outcome. none had an unsatisfactory outcome. two cases had a deep wound infection that subsided after implant removal. none of the cases had other complications.

The distal femoral ‘V’ shaped osteotomy is a simple procedure for the correction of genu valgum in individuals nearing skeletal maturity and is easy to perform. It has the advantage of being wedgeless as it does not cause limb length discrepancy. Internal fixation helps in early rehabilitation after surgery.