استئوتومی گنبدی شکل بالای استخوان ساق جهت اصلاح ژنوواروم در افراد جوان

    Background & Aim: Correction of pure, severe symptomatic geno-varum in young adults is mandatory. High(proximal) tibial osteotomy(HTO) is an accepted procedure for surgical correction of these deformities. In this retrospective survey, the long-term results of 27 osteotomies with a unique method of surgery are presented. Patients & Method: From 1981 to 2001, 27 valgus-producing high tibial osteotomies were performed on twenty patients with symptomatic geno-varum. Osteotomies were done by using modified Maquet’s barrel-vault dome shape method and stabilized by an external fixation device. The mean age of the patients at the time of surgery was 24 (18-30) years and the mean duration of follow-up was 6.7 (2-12) years. Clinical and radiological evaluation was done pre- and post-operatively for all patients and Knee Society Score(KSS) method was applied to evaluate pain relief and functional outcome of knees. Results: Fourteen patients with 21 osteotomies were followed and evaluated for results. During the follow-up, various clinical(recurrence, control of pain) and radiographical(valgus degrees) factors related to the outcome of the knees were assessed. According to Knee Society Score(KSS), there were obvious improvements of scores in patients from 20 preoperatively to 45 in the follow-up period. Varus to valgus angle corrections measured pre- and post-operatively on average changed from 17.5 to 5.5 degrees. Conclusion: Surgical correction of symptomatic geno-varum in young adults without any other knee problems can relieve pain and prevent the phenomenon of progression towards osteoarthritis. Dome shape HTO together with compressive external fixation are very useful methods. The device is not expensive and a good range of the motion of the knee can be achieved sooner.