Supracondylar opening osteotomy in distal femur in patient with genu valgum Report of two cases.

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Hugo Ernesto Villarroel Rovere
María Dolores Delgado Zambrano
Manuel Enrique Betancourt Castillo
Adrián Ernesto Villarroel Pérez

Abstract

Introduction: Opening supracondylar varus osteotomy (OSCVO) to correct genu valgus has good results, but it has complications such as delayed union and nonunion due to internal cortex (hinge) fracture. The incidence of hinge fractures is high. This study aims to describe an additional procedure to the usual external OSCVO technique to prevent internal hinge fracture and report its functional results.


Methods: In two cases that were operated on at the Alcívar Hospital in April 2024, the genu was described as arthritic valgus, the supracondylar opening osteotomy technique was performed, a Steinmann nail and an Acutrak screw were used to fix the internal hinge, and a bench bone graft was placed to fill the opening, which was fixed with a plate. We performed pre- and postsurgical telemetry, assessing the functional results with the KSS scale.


Results: Both patients consulted for valgus deformity and osteoarthritis. In one case, the osteotomy was unicompartmental with pain, and in the other, it was tricompartmental without pain. Postsurgical mobilization was performed immediately. In one patient, the osteotomy consolidated within 2 months, initiating full weight bearing; in the other, it took 3 months.


Discussion: OSCVO has a 93–100% survival rate at 5 years and an 83.3% survival rate at 10 years. Lateral OSCVO is associated with a risk of internal hinge fracture (up to 48%) and, therefore, a higher rate of bone consolidation complications. When we perform an OVSA to correct the axis, the most significant concerns are planning the osteotomy site and preventing hinge fracture with additional percutaneous fixation. After 6 months of evolution, we obtained outstanding functional results.


Conclusions: When the OVSA and contralateral hinge protection were used, favorable results were obtained regarding the function and stability of the affected knee, which is an effective treatment for patients with symptomatic genu valgum.

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How to Cite
Supracondylar opening osteotomy in distal femur in patient with genu valgum: Report of two cases. (2024). Actas Médicas (Ecuador), 34(2), 152-161. https://doi.org/10.61284/216
Section
Case Reports
Author Biographies

Hugo Ernesto Villarroel Rovere, Orthopedics and Traumatology Service, Alcívar Hospital, Guayaquil, Ecuador.

Specialist in Traumatology and Orthopedics from the University of Guayaquil (Guayaquil, 2004). Doctor in Medicine and Surgery from the University of Guayaquil. Orthopedic-Traumatologist, Team member and director of the Orthopedics and Traumatology postgraduate course, Alcívar Hospital, Guayaquil, Ecuador.

María Dolores Delgado Zambrano, Orthopedics and Traumatology Service, Alcívar Hospital, Guayaquil, Ecuador.

Orthopedics and Traumatology Service, Alcívar Hospital, Guayaquil, Ecuador. Treating physician of the Orthopedics and Traumatology Service, Alcívar Hospital, Guayaquil, Ecuador.

Manuel Enrique Betancourt Castillo, Orthopedics and Traumatology Service, Alcívar Hospital, Guayaquil, Ecuador.

General Physician from the National University of Loja (Ecuador, 2020). Resident Physician of the Orthopedics and Traumatology Service, Alcívar Hospital, Guayaquil.

Adrián Ernesto Villarroel Pérez, Orthopedics and Traumatology Service, Alcívar Hospital, Guayaquil, Ecuador.

Medical Doctor from the Catholic University of Santiago de Guayaquil, (Guayaquil 2022). Physician assigned to the Traumatology and Orthopedics Service at Alcívar Hospital.

How to Cite

Supracondylar opening osteotomy in distal femur in patient with genu valgum: Report of two cases. (2024). Actas Médicas (Ecuador), 34(2), 152-161. https://doi.org/10.61284/216

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