EARLY EVALUATION OF POST-CORRECTIVE OSTEOTOMY FOR GENU VARUM AND VALGUM IN CHILDREN AT THE NATIONAL ORTHOPAEDIC HOSPITAL, ENUGU

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EARLY EVALUATION OF POST-CORRECTIVE OSTEOTOMY FOR GENU VARUM AND VALGUM IN CHILDREN AT THE NATIONAL ORTHOPAEDIC HOSPITAL, ENUGU

Abstract

This was a one year prospective study of 58 patients with genu varum and valgum. Thirty four patients with 51 involved knees had genu varum while 24 patients with 32 involved knees had genu valgum.
The study evaluated the early outcome of post-corrective osteotomy for genu varum and valgum in children aged 4-18 years at the National Orthopaedic Hospital, Enugu (NOHE). Standing knee Angle (tibio-femoral angle), intercondylar and intermalleolar distances were measured clinically at initial evaluation pre-operatively and at final assessment (approx. 3-months post correction) when the patient must have commenced full weight bearing. Patients were treated with corrective osteotomy and Plaster of Paris (POP) cast immobilization post–operatively. Subjective outcome was based on patients/guardians and or child’s satisfaction. Objective outcome was based on the above parameters. Outcome was graded using Ferrick and Birch25 criteria into –Complete, Partial and Poor Correction based on Knee Angle measurements.
Of the 51 varus knees, 62.8% had laterally based closing wedge osteotomy while 96.9% of 32 valgus knees had medially based closing wedge osteotomy. Ninety percent of the patients were satisfied with the outcome. Among the varus knees, 35.3% had complete, 58.8% had partial and 5.9% had poor correction. Among valgus knees, 93.75% had Complete while 6.25% had Partial correction. There was no Poor correction. The study showed a negative correlation between age and outcome for genu varum post-correction. There was a complication rate of 43.1% and 9.3% for genu varum and valgum respectively.
Even though the mean deformities in this series were severe, the result of corrective osteotomy is good and compares favourably with results obtained elsewhere.
This study will help surgeons practicing in the hospital and in the region in establishing guidelines for the assessment of corrective osteotomies done for genu varum and valgum.

EARLY EVALUATION OF POST-CORRECTIVE OSTEOTOMY FOR GENU VARUM AND VALGUM IN CHILDREN AT THE NATIONAL ORTHOPAEDIC HOSPITAL, ENUGU

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