title: Distal femoral dome varus osteotomy: surgical technique with minimal dissection and external fixation.
abstract: The results obtained when employing distal femoral varus osteotomy are variable. Our objective was to describe a surgical technique involving minimal dissection, semicircular osteotomy with external fixation for valgus angular deformities, and early weight bearing.
  
  
  METHODS
  
  
  
  METHODS
  Series of cases.
  
  
  METHODS
  Orthopedic Referral Trauma Center.
  
  
  METHODS
  Sixteen patients with valgus angular deformities of >12°.
  
  
  METHODS
  Wedge varus osteotomy, minimal dissection with external fixation using a standard system, multidirectional Newfix. Main outcome measurements included pain, surgical time, knee flexion and extension angles, and assessment of knee function based on the Hospital Special Surgery knee rating scale (HSSkrs).
  
  
  RESULTS
  Of 16 patients, 14 were evaluated to the end of the study. When we compared preoperative values with those obtained postoperatively at a mean of 24±2.1months, pain measurement was reduced from 7 to 2.1 (p=0.002), angle of flexion was reduced from 105.4±14.6° to 105.3±11.1° (p=0.06), and angle of extension, from -1.67 to -1.25° (p=0.6), while HSSkrs assessment increased from 67.5±2.7 to 79.4±5 (p=0.003). Two patients were excluded from the study, one due to infection that developed along the trajectory of a screw, and the other patient underwent complete arthroplasty of the knee, which was performed to combat the pain that was not being alleviated.
  
  
  CONCLUSIONS
  The technique improves function and reduces pain while facilitating early rehabilitation in 83% of cases.
authors.affiliation: Medical Sciences, Knee Specialty Service, Lomas Verdes Unit, Orthopaedic and Traumatologic Hospital, Instituto Mexicano del Seguro Social (IMSS), and Médica Sur Hospital, Mexico City, Mexico. daniello1965@hotmail.com
authors.forename: Daniel
authors.initials: D
authors.lastname: Luna-Pizarro
authors.forename: Francisco
authors.initials: F
authors.lastname: Moreno-Delgado
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: De la Fuente-Zuno
authors.forename: Gerardo
authors.initials: G
authors.lastname: Meraz-Lares
mesh_terms: D016267:External Fixators; D005260:Female; D005269:Femur / Q000601:surgery*; D056304:Genu Valgum / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D016916:Joint Deformities, Acquired / Q000503:physiopathology / Q000601:surgery*; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications; D016059:Range of Motion, Articular; D020127:Recovery of Function