This report is being filed after the review of the following journal article: miranda, m.A., deangelis, j.P., canizares, g.H.And mast, j.W.(2017), double oblique osteotomy: a technique for correction of posttraumatic deformities of the distal femur, journal of orthopaedic trauma, vol.32 (2), pages s60-s65, doi: 10.1097/bot.0000000000001090 (usa).The aim of this study is to describe a series of patients treated with a double oblique osteotomy technique developed by the senior author (j.W.M.), which allows for a single-stage correction of multiplane deformities of the distal femur.Between 1994-2004, a total of 10 patients (5 male and 5 female) were included in the study.Surgery was performed using a 95-degree angled blade (abp) (depuy synthes) was used in 8 patients, a dynamic condylar plate (dcp) (depuy synthes) was used as a waveplate in 1 patient, and a condylar buttress plate (cbp) (depuy synthes) was used in 1 patient.The mean interval between the index fracture repair and double oblique osteotomy was 78 months (range 9¿194 months).The average length of follow-up was 26 months (range 18.5¿42 months).The following complications were reported as follows: (b)(6), a (b)(6) year-old female patient, had a length discrepancy of 1 cm (table 2).Residual flexion deformity was less than 10 degrees.Rotational deformities were corrected to within 5 degrees of neutral.(b)(6), a (b)(6) year-old female patient, had a length discrepancy of 2.5 cm(table 2).Residual flexion deformity was less than 10 degrees.Rotational deformities were corrected to within 5 degrees of neutral.(b)(6), a (b)(6) year-old male patient, had a length discrepancy of 2.5 cm(table 2).Residual flexion deformity was less than 10 degrees.Rotational deformities were corrected to within 5 degrees of neutral.(b)(6), a (b)(6) year-old male patient, had a length discrepancy of 5.1 cm (table 2).Residual flexion deformity was less than 10 degrees.Rotational deformities were corrected to within 5 degrees of neutral.(b)(6), a (b)(6) year-old male patient, had a length discrepancy of 3.2 cm (table 2).Residual flexion deformity was less than 10 degrees.Rotational deformities were corrected to within 5 degrees of neutral.(b)(6), a (b)(6) year-old female patient, had a length discrepancy 2.5 cm (table 2).Residual flexion deformity was less than 10 degrees.Rotational deformities were corrected to within 5 degrees of neutral.(b)(6), a (b)(6) year-old female patient, had a length discrepancy 1.9 cm (table 2).Residual flexion deformity was less than 10 degrees.Rotational deformities were corrected to within 5 degrees of neutral.She requires repeat bone grafting to achieve union.(b)(6), a (b)(6) year-old male patient, had a length discrepancy 7 cm (table 2), a 2.6-mm correction of a 7-cm leg length discrepancy (lld) in which full correction was not the goal.Residual flexion deformity was less than 10 degrees.Rotational deformities were corrected to within 5 degrees of neutral.(b)(6), a (b)(6) year-old female patient, had a length discrepancy of 2.5 cm (table 2).Residual flexion deformity was less than 10 degrees.Rotational deformities were corrected to within 5 degrees of neutral.(b)(6), a (b)(6) year-old male patient, had a length discrepancy of 1.1 cm (table 2).Residual flexion deformity was less than 10 degrees.Rotational deformities were corrected to within 5 degrees of neutral.The average leg length discrepancy (lld) was 2.9 cm (range 1¿7 cm).The average leg length correction was 1.6 cm (0.4¿2.6 cm) or 58 percent of the original lld.4 patients had single-plane deformities (varus), 2 patients had bi-planar deformities (varus and flexion), and 4 patients tri-planar deformities (varus, flexion, and rotation).The average preoperative deformity was 12 degrees of varus angulation (range 0¿20 degrees); 14 degrees of flexion (range 0¿18 degrees); and 26 degrees of rotational deformation (range of 45 degrees external rotation to 36 degrees of internal rotation.) the average correction in the coronal plane was 12 degrees (range of 4¿20 degrees).Three of 5 flexion deformities were corrected to within 5 degrees of normal.One patient required an additional bone graft to achieve union and a second patient complained of local discomfort from prominence of the angled blade plate.The plate was removed 8 months postoperatively with resolution of the patient¿s symptoms.One patient who underwent simultaneous tibial and femoral sustained a sensory deficit in the distribution of the saphenous nerve; however, this deficit resolved during the follow-up period.This report is for one (1) unknown synthes dynamic condylar plate (dcp).This is report 1 of 2 for (b)(4).
|