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. 2019 Sep-Dec;14(3):132-138.
doi: 10.5005/jp-journals-10080-1441.

Correction of Bowleg Deformity in Achondroplasia through Combined Bony Realignment and Lateral Collateral Ligament Tightening

Binu T Kurian  1 , Mohan V Belthur  2 , Stanley Jones  1 , Stephen N Giles  1 , James A Fernandes  1
Affiliations

Correction of Bowleg Deformity in Achondroplasia through Combined Bony Realignment and Lateral Collateral Ligament Tightening

Binu T Kurian et al. Strategies Trauma Limb Reconstr. 2019 Sep-Dec.

Abstract

Introduction: Achondroplasia is one of the most common osteochondrodysplasias with an incidence of 1 in 26,000 live births. Bowing of lower limbs can cause significant morbidity in this population. The use of the Ilizarov external fixator to tighten collateral ligaments of the knee in children has not been reported in the literature. We report the technique and early results of lateral collateral ligament (LCL) tightening with correction of genu varum in children with achondroplasia.

Materials and methods: A retrospective review of children with achondroplasia presenting with bowleg deformity who were treated by corrective osteotomy and LCL tightening was conducted. Between 1998 and 2003, 12 patients (24 limb segments) underwent this procedure and were included in the study. All patients had grade III LCL laxity preoperatively. Pre- and postoperative anteroposterior standing mechanical axis radiographs were evaluated. The final outcome was graded using the grading system of Paley et al.

Results: All patients had bilateral corrections. The Ilizarov external fixator was used in 10 patients and the Orthofix limb reconstruction system in 2 patients. The bony realignment was achieved through monofocal or bifocal tibial osteotomies. The LCL was tightened in all limb segments using the Paley's type II strategy. The final result was graded as excellent in 20 limb segments and good in 4 limb segments. One patient developed transient common peroneal nerve palsy, four developed grade II pin site infections, and there was premature consolidation of the tibial regenerate in one patient.

How to cite this article: Kurian BT, Belthur MV, Jones S, et al. Correction of Bowleg Deformity in Achondroplasia through Combined Bony Realignment and Lateral Collateral Ligament Tightening. Strategies Trauma Limb Reconstr 2019;14(3):132-138.

Keywords: Achondroplasia; Bowlegs; Genu varum; Ilizarov; Lateral collateral ligament.

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Conflict of interest statement

Source of support: Nil Conflict of interest: None

Figures

Fig. 1A and B
Fig. 1A and B
Case 1: Preoperative clinical picture
Fig. 2
Fig. 2
Case 1: Preoperative planning X-ray
Fig. 3
Fig. 3
Closeup view of the knee joints
Fig. 4
Fig. 4
Case 1: Postoperative X-ray
Fig. 5
Fig. 5
Case 1: Follow-up X-ray with regenerate
Fig. 6
Fig. 6
Case 1: Consolidation of regenerate
Fig. 7
Fig. 7
Case 1: Post-lateral collateral ligament lengthening fibula at anatomical position
Fig. 8A and B
Fig. 8A and B
Case 1: Final clinical picture
Fig. 9A to C
Fig. 9A to C
Case 2: Preoperative clinical picture
Fig. 10
Fig. 10
Case 2: Postoperative X-ray
Fig. 11
Fig. 11
Case 2: Post-correction
Fig. 12
Fig. 12
Case 2: Final X-ray–fibula in anatomical position
Fig. 13A to C
Fig. 13A to C
Case 2: Final clinical picture
See this image and copyright information in PMC

References

    1. Shapiro F. Skeletal dysplasias. Paediatric lower limb deformities. 2001.. pp. pp. 733––871.. In:
    1. Ponseti IV. Skeletal growth in achondroplasia. J Bone Joint Surg. 1970;;52-A((4):):70.. doi: 10.2106/00004623-197052040-00004. DOI: - DOI - PubMed
    1. Kopits SE. Orthopaedic complications of dwarfism. Clin Orthop. 1976;;114((114):):153––179.. - PubMed
    1. Kopits SE. Genetics clinics of the John Hopkins hospital. surgical intervention in achondroplasia. Correction of bowleg deformity in achondroplasia. Johns Hopkins Med J. 1980;;146((5):):206––209.. - PubMed
    1. Bailey JA. Orthopaedic aspects of achondroplasia. J Bone Joint Surg. 1970;;52-A((7):):1285––1301.. doi: 10.2106/00004623-197052070-00001. DOI: - DOI - PubMed

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