[Distal femoral varus osteotomy for symptomatic genu valgum: long-term results and review of the literature].
OBJECTIVE
We report our experience with eleven patients treated for disabling genu valgum from 1979 to 1994.


METHODS
Genu valgum resulted from femoral deformation in all patients. Ten had a congenital condition and one a post-traumatic knee. IKS scores were used for the clinical evaluation. The lateral femorotibial joint space and the lateral femoral angle (LFA) were measured on plain films. Goniometry was used to measure the axis of the loaded lower limb. All patients underwent osteotomy of the distal femur for varisation and plate fixation. One patient required revision for a unicompartment lateral prosthesis subsequent to fracture of the homolateral lateral tibial plateau. Mean follow-up was 10.5 years (3.5-21.5).


RESULTS
There were no cases of nonunion. Four patients had a good or excellent knee score. Eight patients had a good or excellent function score. Osteoarthritis worsened in two patients. The mean LFA increased from 72.5 degrees preoperatively to 83.5 degrees postoperatively and a last follow-up. Mean genu valgum was 13 degrees preoperatively and 2 degrees at last follow-up. All patients except one were satisfied or very satisfied. Insufficient correction appeared to be the main complaint.


CONCLUSIONS
These results and results reported in the literature demonstrate that distal femoral osteotomy for disabling genu valgum is an effective treatment if the correction is complete and osteosynthesis effective, providing long lasting results when femoral deformation is involved and osteoarthritis limited.
Zilber
S
S
Service d'Orthopédie et de Traumatologie, Hôpital Lariboisière (Faculté de Médecine Saint-Louis-Lariboisière, Université Paris X), 2, rue Ambroise-Paré, 75010 Paris. sebastien.zilber@wanadoo.fr
Larrouy
M
M
Sedel
L
L
Nizard
R
R
D000328:Adult; D000368:Aged; D005260:Female; D005269:Femur; D006801:Humans; D007592:Joint Diseases / Q000601:surgery; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D013997:Time Factors