title: Distal femoral osteotomy using the LCP pediatric condylar 90-degree plate in patients with neuromuscular disorders.
abstract: BACKGROUND
  In patients with cerebral palsy and other neuromuscular disorders, correction of a fixed knee flexion deformity is thought to be crucial for the improvement of gait. The distal femoral extension osteotomy (DFO) is one method to achieve this goal. The standard implant for fixation of the 2 fragments in DFO is the conventional AO blade plate. The aim of this study was to report the outcome of using the new LCP Pediatric Condylar 90-Degree Plate for DFO.
  
  
  METHODS
  Thirty-eight patients undergoing 63 DFOs were included. The mean age was 16.3±4.4 years (range, 4 to 27 y) at the time of surgery. Thirty-two patients had a diagnosis of cerebral palsy and 6 patients had other neuromuscular disorders including myelomeningocoele and arthrogryposis. Thirteen patients had unilateral procedures and 25 had bilateral procedures.
  
  
  RESULTS
  The mean duration of the surgical intervention was 67.9±26.5 minutes (range, 30 to 180 min) and the mean blood loss was 100.0±42.1 mL (range, 50 to 250 mL). In 84% of the cases, large-fragment (5.0 mm) implants were used. The mean extension correction in 84% of the patients (n=53) was 22.8±10.3 degrees (range, 5 to 50 degrees). In this series, there were 2 complications in 63 osteotomies (3%). Radiologic follow-up of the cohort was until the time of plate removal (14.2±4.3 mo; range, 6 to 26 mo). Three months after the index operation, all osteotomies were radiologically consolidated. At this time and at plate removal, there were no malunions or nonunions in this cohort. Clinical follow-up of the cohort was performed until the end of the study (mean 35.5±6.7 mo; range, 22 to 46 mo). At the end of the study, 59 plates (94%) had been removed.
  
  
  CONCLUSIONS
  The new LCP Pediatric Condylar 90-Degree Plate provides stable and safe fixation of distal femoral correction osteotomies in patients with neuromuscular disorders.
  
  
  METHODS
  Level IV.
authors.affiliation: Pediatric Orthopaedic Department, University Children's Hospital Basle UKBB, Basle, Switzerland. erich_rutz@hotmail.com
authors.forename: Erich
authors.initials: E
authors.lastname: Rutz
authors.forename: Mark S
authors.initials: MS
authors.lastname: Gaston
authors.forename: Carlo
authors.initials: C
authors.lastname: Camathias
authors.forename: Reinald
authors.initials: R
authors.lastname: Brunner
mesh_terms: D000293:Adolescent; D000328:Adult; D001860:Bone Plates; D002648:Child; D002675:Child, Preschool; D020878:Device Removal; D005269:Femur / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009468:Neuromuscular Diseases / Q000503:physiopathology / Q000601:surgery*; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult