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Journal articles on the topic 'Lateral closing wedge'

Author: Grafiati

Published: 4 June 2021

Last updated: 14 February 2022

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1

van Raaij, Tom M., and Reinoud W. Brouwer. "Proximal Tibial Valgus Osteotomy: Lateral Closing Wedge." JBJS Essential Surgical Techniques 5, no. 4 (2015): e26. http://dx.doi.org/10.2106/jbjs.st.n.00104.

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2

Lustig, Sebastien, Elvire Servien, Cecile Batailler, Philippe Neyret, and Simone Cerciello. "Correction of Tibial Valgus Deformity." Journal of Knee Surgery 30, no. 05 (2017): 421–25. http://dx.doi.org/10.1055/s-0037-1603504.

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AbstractValgus tibial malalignment may be the result of bony deformity, previous lateral meniscectomy, or lateral plateau fractures. The correction of such a problem is usually addressed through a tibial osteotomy, which affects the alignment both in flexion and extension. Two surgical options are available: medial closing wedge and lateral opening wedge. When planning a varisation osteotomy, it should be considered that the normal joint line is in 3 degrees of varus. Increasing this obliquity beyond 10 to 15 degrees ends up with increased loads on the patellofemoral joint and medial subluxation of the femur on the tibia. The aim of the present study was to discuss actual indications and contraindications for a varus-producing high tibial osteotomy and describe surgical steps of both medial closing wedge and lateral opening wedge techniques. In addition, the available literature has been searched to report functional outcomes and complications.

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3

Kim, Tae Woo, Myung Chul Lee, Jae Ho Cho, Jong Seop Kim, and Yong Seuk Lee. "The Ideal Location of the Lateral Hinge in Medial Closing Wedge Osteotomy of the Distal Femur: Analysis of Soft Tissue Coverage and Bone Density." American Journal of Sports Medicine 47, no. 12 (2019): 2945–51. http://dx.doi.org/10.1177/0363546519869325.

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Background: Although an appropriate hinge position to prevent unstable lateral hinge fractures is well established in medial opening wedge high tibial osteotomy, the position during medial closing wedge distal femoral osteotomy has not been elucidated. Purpose/Hypothesis: The purpose was to evaluate the ideal hinge position that would prevent an unstable lateral hinge fracture during biplanar medial closing wedge distal femoral osteotomy based on soft tissue coverage and bone density around the hinge area. The hypothesis was that the ideal hinge position could be clarified by analyzing soft tissue coverage and bone density around the lateral hinge area. Study Design: Controlled laboratory study. Methods: In 20 cadaveric knees (mean age, 70.3 ± 19.2 years), the femoral attachment of the gastrocnemius lateral head was quantitatively analyzed as a soft tissue stabilizer using digital photography and fluoroscopy. Then, medial closing wedge distal femoral osteotomy was performed, locating the lateral hinge either inside (group 1) or outside (group 2) the femoral attachment of the gastrocnemius lateral head, and the incidence of unstable lateral hinge fractures was compared between the 2 groups. Cortical bone density around the lateral hinge was measured using Hounsfield units on 30 computed tomography scans and reconstructed as a 3-dimensional mapping model. The transitional zone with low bone density was regarded as the safe hinge position with an increased capacity for bone deformation. Results: The upper and lower margins of the femoral attachment of the gastrocnemius lateral head were 9.1 ± 0.9 mm above and 8.0 ± 1.4 mm below the upper border of the lateral femoral condyle, respectively, and the femoral attachment of the gastrocnemius lateral head was widest in the anteroposterior dimension 0.4 ± 1.7 mm above the upper border of the lateral femoral condyle. The incidence of unstable lateral hinge fractures during osteotomy was significantly decreased in group 1 compared with group 2 (group 1: 0/10; group 2: 5/10; P = .01). An isolated transitional zone with low bone density was observed in all 30 knees and located 1.3 ± 0.8 mm above the upper border of the lateral femoral condyle. Bone density of the transitional zone with low bone density was significantly lower than surrounding femoral cortices ( P < .001). Conclusion: Only the upper border of the lateral femoral condyle can be recommended as an ideal hinge position to prevent unstable lateral hinge fractures during biplanar medial closing wedge distal femoral osteotomy based on soft tissue coverage and bone density. Clinical Relevance: When the hinge is positioned at the upper border of the lateral femoral condyle during biplanar medial closing wedge distal femoral osteotomy, the risk of unstable hinge fractures can be minimized.

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4

Nha, Kyung-Wook, Yong Chang, Oog-Jin Shon, et al. "Where is the Target Point to Prevent Cortical Hinge Fracture in Medial Closing-Wedge Distal Femoral Varus Osteotomy?" Journal of Knee Surgery 32, no. 03 (2018): 274–79. http://dx.doi.org/10.1055/s-0038-1641144.

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AbstractThe purpose of this study was to investigate whether the location of the hinge affects the incidence of hinge fracture during medial closing-wedge distal femoral varus osteotomy (DFVO). Twenty knees from 10 fresh-frozen human cadavers (mean age, 75 ± 17 years) were used to perform uniplanar medial closing-wedge DFVO with a 7-mm wedge. Each specimen was randomly assigned to either group A (supracondylar hinge) or group B (lateral condylar hinge). The incidence of hinge fracture and stability was compared between both groups after uniplanar medial closing-wedge DFVO. In group A, 8 of 10 knees had a lateral cortex fracture during closure of the osteotomy gap, and all fractured knees were unstable. Two knees with an intact lateral cortical hinge showed stability under manual valgus and varus forces. After intentional breakage of the lateral cortical hinge, both knees were found to be unstable under the same force. In group B, 2 of 10 knees had a lateral cortex fracture, and 8 knees had no fractures. All specimens were found to be stable under manual valgus and varus forces. After intentional breakage of the lateral cortical hinge in group B, 2 knees were unstable, while 8 knees remained stable. This study showed a significantly higher incidence of lateral cortical hinge fracture and instability in group A than in group B during closure of the osteotomy gap.

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5

Kandel, Prakriti Raj, Rajiv Baral, Niva Chitrakar, Gyaneshwar Prasad Singh, and Laxmi Pathak. "Lateral Closing Wedge Osteotomy for Cubitus Varus: A Case Report." Journal of Universal College of Medical Sciences 4, no. 2 (2018): 43–45. http://dx.doi.org/10.3126/jucms.v4i2.19092.

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Supracondylar fracture is the most common fracture in children and yet are not treated timely or properly leading to various complications, cubitusvarus being the most common delayed complication1-5. There are various osteotomies that have been proposed for correcting cubitusvarus, but they all have their limitations. In this case study, we have reviewed the functional and cosmetic results of a simple lateral closing wedge osteotomy. A lateral closing wedge osteotomy was done for cubitusvarus of the right elbow of a 17 years old girl following a neglected supracondylar fracture of the right humerus.The carrying angle which was 18⁰ preoperatively became 12⁰ postoperatively following which the patient did not have any difficulty in fully flexing the elbow and could swing her upper limb freely while walking. Closing wedge supracondylar osteotomy is an effective treatment for cubitusvarus both functionally and cosmetically. Journal of Universal College of Medical Sciences (2016) Vol.04 No.02 Issue 14, page: 43-45

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6

Ro, Du Hyun, Sahnghoon Lee, Sang Cheol Seong, and Myung Chul Lee. "Lateral Closing Wedge Osteotomy of Tibia for Degenerative Arthritis." Journal of the Korean Orthopaedic Association 49, no. 2 (2014): 95. http://dx.doi.org/10.4055/jkoa.2014.49.2.95.

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7

Garcia-Elias, M., K. N. An, W. P. Cooney, and R. L. Linscheid. "Lateral closing wedge osteotomy for treatment of Kienböck's disease." Annales de Chirurgie de la Main et du Membre Supérieur 17, no. 4 (1998): 283–90. http://dx.doi.org/10.1016/s0753-9053(98)80027-6.

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8

Kraus, Jonathan C., Mark T. Fischer, Jeremy J. McCormick, Sandra E. Klein, and Jeffrey E. Johnson. "Geometry of the Lateral Sliding, Closing Wedge Calcaneal Osteotomy." Foot & Ankle International 35, no. 3 (2013): 238–42. http://dx.doi.org/10.1177/1071100713518188.

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9

Kim, Sung Soo, and Wook Kim. "Lateral Condyle Prominence Following Lateral Closing Wedge Osteotomy for Cubitus Varus Deformity." Journal of the Korean Orthopaedic Association 39, no. 4 (2004): 409. http://dx.doi.org/10.4055/jkoa.2004.39.4.409.

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10

Pandey, S., A. Shrestha, S. Dhakal, G. Neupane, and AP Regmi. "Cubitus varus in adults correction with lateral closing wedge osteotomy and fixation with posterior plating." Journal of College of Medical Sciences-Nepal 8, no. 2 (2012): 49–53. http://dx.doi.org/10.3126/jcmsn.v8i2.6839.

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To share the result of lateral closing wedge osteotomy and fixation with posterior reconstruction plate in correction of cubitus varus in adults. It is a retrospective case analysis of 8 cases of cubitus varus in adult treated with lateral closing wedge osteotomy through posterior triceps retracting approach. Internal fixation was done with two posterior reconstruction plates. All cases were from 15 to 29 years of age (mean 22.3 ) with 3 female and 5 male. All had cubitus varus ranging from 15- 28 deg (mean 20.16 deg) due to childhood malunited supracondylar fracture of humerus. Indication for operation was cosmetic reason only. Follow up duration was 4-22 months (mean 12.5 months). All the osteotomy united clinically in mean duration of 9 weeks ( range 8-12 weeks) with mean carrying angle 8.33 degree in postoperative phase. There was no loss of motion, no loss of fixation, no surgical site infection, nonunion or neurovascular deficit. Lateral closing wedge corrective osteotomy and fixation with posterior reconstruction plate is easy technique with satisfactory result in correction of cubitus varus in adults. Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-2, 49-53 DOI: http://dx.doi.org/10.3126/jcmsn.v8i2.6839

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11

Duke, HF. "Rotational scarf (Z) osteotomy bunionectomy for correction of high intermetatarsal angles." Journal of the American Podiatric Medical Association 82, no. 7 (1992): 352–60. http://dx.doi.org/10.7547/87507315-82-7-352.

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A modification of the scarf osteotomy bunionectomy is described. The modification involves a change in the movement of the osseous fragments from lateral transposition to lateral rotation of the metatarsal head fragment around a stationary axis at the metatarsal base. Rotation of the distal fragment in this manner allows greater than 50% transposition and, therefore, higher intermetatarsal angle corrections can be obtained as compared to a transpositional scarf osteotomy. The configuration of the scarf osteotomy is more stable to the stress of weightbearing than the closing base wedge osteotomy, and this modification can provide a useful alternative to closing base wedge osteotomy for the correction of severe hallux valgus deformity.

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12

Nagi, O. N., Senthil Kumar, and Sameer Aggarwal. "Combined Lateral Closing and Medial Opening- Wedge High Tibial Osteotomy." Journal of Bone and Joint Surgery-American Volume 89, no. 3 (2007): 542–49. http://dx.doi.org/10.2106/00004623-200703000-00011.

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13

Nagi, O. N., Senthil Kumar, and Sameer Aggarwal. "Combined Lateral Closing and Medial Opening-Wedge High Tibial Osteotomy." Journal of Bone & Joint Surgery 89, no. 3 (2007): 542–49. http://dx.doi.org/10.2106/jbjs.e.01089.

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14

Deokar Sharma, Bharati Pankaj, and Pankaj Nandkishor Sharma. "Evaluation of management of malunited supracondylar fracture of humerus by lateral closing wedge osteotomy." International Journal of Research in Orthopaedics 5, no. 1 (2018): 99. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20185329.

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<p class="abstract"><strong>Background:</strong> Various osteotomies have been in use for correction of varus deformity at elbow secondary to malunited supracondylar humerus fracture in children. The objectives of the study were to determine the efficacy &amp; outcome of lateral closing wedge osteotomy in children as a treatment of malunited supracondylar fracture of humerus with cubitus varus and to evaluate various technical problems, morbidity, complications of Lateral closing wedge osteotomy and to suggest ways to overcome them.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted among 50 cases of malunited supracondylar fracture of humerus who visited in OPD during 1st September 2008 to 31st August 2010. After pre-operative assessment, lateral closing wedge osteotomy was done and fixed with two 3.5 mm screws, figure of eight tension band stainless steel wire and a supplemental lateral k-wire. Post operatively x-ray of patient was taken and carrying angle and range of movement were calculated. Patients were re-assessed at complete union.<strong></strong></p><p class="abstract"><strong>Results:</strong> Maximum patients were from the age group of 8 to 10 years- 22 cases, mean age 13.08 years, 80% male. Left (non-dominant) side was involved in 30 (60%) cases. Around 18% cases developed complications. 25 (50%) patients had no loss of range of movement and 2 (4%) had 16 to 20 degrees loss of range of movement. Almost 36 (72%) cases had excellent outcome, 11 (22%) cases had good outcome, 3 (6%) cases had poor outcome due to loss of fixation, 47 (94%) patients/parents were satisfied with the final outcome.</p><p class="abstract"><strong>Conclusions:</strong> Lateral closing wedge osteotomy with a lateral K-wire is a sound, cost-effective, technically less demanding modality of treatment for varus deformity due to malunited supracondylar fracture of humerus in children with minimum complications.</p>

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15

Lee, Soon Chul, Jong Sup Shim, Eun Jin Sul, and Sung Wook Seo. "Remodeling After Lateral Closing-wedge Osteotomy in Children With Cubitus Varus." Orthopedics 35, no. 6 (2012): e823-e828. http://dx.doi.org/10.3928/01477447-20120525-19.

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16

Brower, Barry, Ann Peruski, Antonio Pozzi, et al. "Distal femoral lateral closing wedge osteotomy as a component of comprehensive treatment of medial patellar luxation and distal femoral varus in dogs." Veterinary and Comparative Orthopaedics and Traumatology 30, no. 01 (2017): 20–27. http://dx.doi.org/10.3415/vcot-16-07-0103.

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SummaryObjective: To describe a cohort of dogs with medial patellar luxation managed with a distal femoral lateral closing wedge ostectomy (DFO) as a component of comprehensive treatment, and to report radiographic and long-term clinical outcome of this technique.Methods: Medical records of dogs that had a lateral closing wedge DFO as part of management of medial patellar luxation at three veterinary teaching hospitals were reviewed. Surgical reports as well as the preoperative, postoperative, and follow-up radiographs were reviewed. The anatomical lateral distal femoral angle (aLDFA) was determined. Long-term clinical outcome was assessed by telephone interview with the owner.Results: A lateral closing wedge DFO was performed on 66 limbs. The mean pre- and postoperative aLDFA was 107.6° ± 5.8° and 94.1° ± 4.2°, respectively. Cranial cruciate ligament disease was identified in 28/66 affected limbs. Tibial angular deformity, torsional deformity, or both was identified in nine of the 66 limbs. Ostectomy healing was confirmed radiographically in 51/66 limbs. The mean time to union was 73 ± 37 days. All patellae were in the normal position and stable. Complications included infection (2/51), fixation failure (1/51), delayed healing (2/51), and persistent lameness (1/51).Clinical significance: In this cohort of cases, DFO was a highly successful and repeatable component of surgical treatment for dogs with medial patellar luxation associated with femoral varus. This study also provides more evidence of the high rate of concurrent cranial cruciate ligament disease in cases of medial patellar luxation complicated by fe-moral varus, and supports an association between stifle instability and medial patellar luxation.

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17

Ogawa, Hiroyasu, Kazu Matsumoto, and Haruhiko Akiyama. "Effects of lateral opening wedge and medial closing wedge distal femoral osteotomies on axial load stability." Knee 27, no. 3 (2020): 760–66. http://dx.doi.org/10.1016/j.knee.2020.04.019.

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18

Okubo, Hirotaka, Chojo Futenma, Hideyuki Sunagawa, Masaki Kinjo, and Fuminori Kanaya. "Very Distal Radius Wedge Osteotomy for Kienböck’s Disease: Case Series." Journal of Hand Surgery (Asian-Pacific Volume) 22, no. 04 (2017): 490–96. http://dx.doi.org/10.1142/s0218810417500551.

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Background: Radius osteotomy is one of the standard surgical procedures for the treatment of Kienböck’s disease. Unfortunately, radius osteotomy can result in an incongruous distal radio-ulnar joint (DRUj) postoperatively, because the procedure is performed proximal to the DRUj. Methods: A very distal radius wedge osteotomy was performed as a 15-degree lateral closing wedge osteotomy with the apex of the wedge distal to that of conventional lateral closing wedge osteotomy; this procedure was developed to avoid postoperative incongruous DRUj. We performed this procedure on 6 patients (stage III-A: 1, stage III-B: 5) with a mean age of 49 years. Clinical and radiographic evaluations were performed at a mean follow-up of 32 months. Results: Wrist pain disappeared in all patients. Mean grip strength improved from 35% to 87% of the contralateral side (p = 0.0255). Mean range of motion, measured as flexion-extension arc, improved from 93 to 128 degrees. Nakamura’s score was good in all patient. Mean lunate covering ratio increased from 61% to 90% (p = 0.0151) and mean sigmoid notch inclination angle, a radiographic parameter of DRUj congruency, was not significantly different between pre-operative and final follow-up evaluation. No clinical or radiographic DRUj osteoarthritis findings were observed. Conclusions: Our procedure of very distal radius wedge osteotomy provided satisfactory clinical results without an incongruous DRUj. This technique might prevent the occurrence of postoperative DRUj osteoarthritis.

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19

Nyska, Meir, Hans-Jörg Trnka, Brent G. Parks, and Mark S. Myerson. "Proximal Metatarsal Osteotomies: A Comparative Geometric Analysis Conducted on Sawbone Models." Foot & Ankle International 23, no. 10 (2002): 938–45. http://dx.doi.org/10.1177/107110070202301009.

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We evaluated the change in position of the first metatarsal head using a three-dimensional digitizer on sawbone models. Crescentic, closing wedge, oblique shaft (Ludloff 8° and 16°), reverse oblique shaft (Mau 8° and 16°), rotational “Z” (Scarf), and proximal chevron osteotomies were performed and secured using 3-mm screws. The 16° Ludloff provided the most lateral shift (9.5 mm) and angular correction (14.5°) but also produced the most elevation (1.4 mm) and shortening (2.9 mm). The 8° Ludloff provided lateral and angular corrections similar to those of the crescentic and closing wedge osteotomies with less elevation and shortening. Because the displacement osteotomies (Scarf, proximal chevron) provided less angular correction, the same lateral displacement, and less shortening than the basilar angular osteotomies, based upon this model they can be more reliably used for a patient with a mild to moderate deformity, a short first metatarsal, or an intermediate deformity with a large distal metatarsal articular angle. These results can serve as recommendations for selecting the optimal osteotomy with which to correct a deformation.

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20

Okahara, Goichi, Fuminori Kanaya, Chojo Futenma, et al. "Lateral Closing Wedge Osteotomy of Humerus for Osteochondritis Dissecans of the Capitellum." Orthopedics & Traumatology 50, no. 1 (2001): 178–82. http://dx.doi.org/10.5035/nishiseisai.50.178.

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21

Greenhill, Dustin A., Scott H. Kozin, Michael Kwon, and Martin J. Herman. "Oblique Lateral Closing-Wedge Osteotomy for Cubitus Varus in Skeletally Immature Patients." JBJS Essential Surgical Techniques 9, no. 4 (2019): e40. http://dx.doi.org/10.2106/jbjs.st.18.00107.

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22

Choufani, C., O. Barbier, and G. Versier. "Patellar lateral closing-wedge osteotomy in habitual patellar dislocation with severe dysplasia." Orthopaedics & Traumatology: Surgery & Research 101, no. 7 (2015): 879–82. http://dx.doi.org/10.1016/j.otsr.2015.07.019.

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23

Kuhn, Harald, and Manfred Thomas. "Supramalleolar lateral closing wedge osteotomy for the treatment of varus ankle arthrosis." Fuß & Sprunggelenk 5, no. 4 (2007): 279. http://dx.doi.org/10.1016/s1619-9987(08)60438-9.

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24

Harstall, Roger, Oliver Lehmann, Fabian Krause, and Martin Weber. "Supramalleolar Lateral Closing Wedge Osteotomy for the Treatment of Varus Ankle Arthrosis." Foot & Ankle International 28, no. 5 (2007): 542–48. http://dx.doi.org/10.3113/fai.2007.0542.

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25

Howells, N. R., L. Salmon, A. Waller, J. Scanelli, and L. A. Pinczewski. "The outcome at ten years of lateral closing-wedge high tibial osteotomy." Bone & Joint Journal 96-B, no. 11 (2014): 1491–97. http://dx.doi.org/10.1302/0301-620x.96b11.33617.

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26

Gong, Hyun Sik, Moon Sang Chung, Joo Han Oh, Hoyune Esther Cho, and Goo Hyun Baek. "Oblique Closing Wedge Osteotomy and Lateral Plating for Cubitus Varus in Adults." Clinical Orthopaedics and Related Research 466, no. 4 (2008): 899–906. http://dx.doi.org/10.1007/s11999-008-0164-0.

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27

Marcheggiani Muccioli, Giulio Maria, Stefano Fratini, Eugenio Cammisa, et al. "Lateral Closing Wedge High Tibial Osteotomy for Medial Compartment Arthrosis or Overload." Clinics in Sports Medicine 38, no. 3 (2019): 375–86. http://dx.doi.org/10.1016/j.csm.2019.02.002.

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28

Wylie, James D., Daniel L. Jones, Melissa K. Hartley, et al. "Distal Femoral Osteotomy for the Valgus Knee: Medial Closing Wedge Versus Lateral Opening Wedge: A Systematic Review." Arthroscopy: The Journal of Arthroscopic & Related Surgery 32, no. 10 (2016): 2141–47. http://dx.doi.org/10.1016/j.arthro.2016.04.010.

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29

Amzallag, J., Nicolas Pujol, A. Maqdes, P. Beaufils, T. Judet, and Y. Catonne. "Patellar height modification after high tibial osteotomy by either medial opening-wedge or lateral closing-wedge osteotomies." Knee Surgery, Sports Traumatology, Arthroscopy 21, no. 1 (2012): 255–59. http://dx.doi.org/10.1007/s00167-012-2304-z.

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Getgood, Alan, and Ryan Degen. "Implant Alternatives for Tibial Osteotomies." Journal of Knee Surgery 30, no. 05 (2017): 426–34. http://dx.doi.org/10.1055/s-0037-1603505.

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AbstractTibial osteotomies have commonly been used to treat varus malalignment with associated medial compartment degeneration. Initially, lateral closing wedge osteotomies were commonly used. However, with the advent of improved plate osteosynthesis techniques, medial opening wedge osteotomies have become the mainstay of treatment. Presently, there are several available fixation devices, with no clear consensus on which represents the superior option. This article will serve to review the technological evolution of tibial osteotomy fixation devices, highlighting the comparative biomechanical evidence of available constructs.

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Nha, Kyung Wook, Yoonwon Ha, Seungmin Oh, et al. "Surgical Treatment With Closing-Wedge Distal Femoral Osteotomy for Recurrent Patellar Dislocation With Genu Valgum." American Journal of Sports Medicine 46, no. 7 (2018): 1632–40. http://dx.doi.org/10.1177/0363546518765479.

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Background: Closing-wedge distal femoral osteotomy (CWDFO)—combined with medial reefing and lateral release, if necessary— has been used to treat recurrent patellar dislocation (RPD) with genu valgum. Purpose: To evaluate the clinical and radiologic outcomes of surgical treatment with CWDFO for treatment of RPD with genu valgum. Study Design: Case series; Level of evidence, 4. Methods: Fourteen consecutive patients (23 knees) with RPD and genu valgum were treated with CWDFO. Patients with a minimum 2-year follow-up period were eligible for this study. Patients with prior failed surgery were also eligible. Radiographic evaluation was performed with mechanical femorotibial and lateral distal femoral angle. The radiographic parameters presenting patellar positions and pathologic abnormalities associated with RPD were evaluated. Chondral lesion changes in second-look arthroscopic examination were examined, and clinical outcomes (eg, occurrence of redislocation, range of motion, and clinical scores) were assessed pre- and postoperatively at a minimum of 2 years. Results: At a mean follow-up of 30.7 months (range, 25-62 months), the mean mechanical femorotibial and mechanical lateral distal femoral angles changed significantly from valgus 5° (range, 2°-11°) to varus 3° (2°-11°; P < .001) and from 83° (range, 78°-86°) to 89° (84°-92°; P < .001), respectively. The mean patellar congruence angle improved from 40° lateral (range, 20°-53° lateral) to 4° medial (23° medial to 21° lateral; P < .001), as did the lateral patellofemoral angle from 26° (range, 8°-62°) to 9° (0°-15°; P < .001). Computed tomography scans showed that the mean distance of patellar lateral shift decreased from 13.5 mm (range, 4-22 mm) to 2.0 mm (–4 to 5 mm; P < .001). The mean tibial tubercle to trochlear groove distance significantly decreased from 20.4 to 13.5 mm ( P < .001), while the Caton-Deschamps ratio did not change significantly after surgery ( P = .984). Chondral lesions of the patella and trochlear groove significantly improved or were maintained. None of the patients experienced subluxation or redislocation after surgery. Patellar instability symptoms also improved, as validated by radiographic and other clinical outcomes. Conclusion: CWDFO combined with medial reefing and lateral release successfully treated RPD with genu valgum for a minimum follow-up of 2 years, with improved patellar alignment and stability.

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32

Lakhotia, Dr Devendra, Dr Kartikeya Sharma, and Dr Madharam Bishnoi. "Step cut closing wedge osteotomy and lateral plating for cubitus varus in adults." International Journal of Orthopaedics Sciences 6, no. 1 (2020): 565–69. http://dx.doi.org/10.22271/ortho.2020.v6.i1j.1925.

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33

Sambandam, Murugasarathy, Kalaiyarasan Thamizharasan, Duraisamy Ezhilmaran, and Maharajothi Paramasivam. "MANAGEMENT OF CUBITUS VARUS DEFORMITY BY LATERAL CLOSING WEDGE OSTEOTOMY- A CASE SERIES." Journal of Evolution of Medical and Dental Sciences 6, no. 27 (2017): 2275–77. http://dx.doi.org/10.14260/jemds/2017/489.

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34

Agarwala, S., and SB Shah. "Staple versus Locking Compression Plate Fixation after Lateral Closing Wedge High Tibial Osteotomy." Journal of Orthopaedic Surgery 16, no. 3 (2008): 303–7. http://dx.doi.org/10.1177/230949900801600307.

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35

Wylie, James D., and Travis G. Maak. "Medial Closing-Wedge Distal Femoral Osteotomy for Genu Valgum With Lateral Compartment Disease." Arthroscopy Techniques 5, no. 6 (2016): e1357-e1366. http://dx.doi.org/10.1016/j.eats.2016.08.009.

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36

Dhara, Jagat Jyoti. "A PROSPECTIVE COMPARATIVE STUDY BETWEEN MEDIAL OPENING WEDGE AND LATERAL CLOSING WEDGE HIGH TIBIAL OSTEOTOMY IN OSTEOARTHRITIS KNEE." Journal of Evidence Based Medicine and Healthcare 5, no. 28 (2018): 2095–99. http://dx.doi.org/10.18410/jebmh/2018/434.

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Voleti, Pramod B., Isabella T. Wu, Ryan M. Degen, Danielle M. Tetreault, Aaron J. Krych, and Riley J. Williams. "Successful Return to Sport Following Distal Femoral Varus Osteotomy." CARTILAGE 10, no. 1 (2017): 19–25. http://dx.doi.org/10.1177/1947603517743545.

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Objective Distal femoral varus osteotomy (DFVO) is an effective treatment for unloading valgus knee malalignment; however, there is limited evidence on the ability for patients to return to athletics following this procedure. The purpose of this study is to report the functional outcomes and rate of return to sport for athletes that underwent DFVO. Design A consecutive series of athletes that had undergone DFVO were retrospectively reviewed. Radiographs were assessed to determine preoperative and postoperative alignment. Institutional registries were used to collect preoperative and postoperative Marx Activity Scale, International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form scores, and return to sport. Results Thirteen patients (8 males, 5 females) with a mean age of 24 years (range 17-35 years) and a mean follow-up of 43 months (range 24-74 months) were included in the study. Six patients underwent medial closing wedge DFVO versus 7 patients who underwent lateral opening wedge DFVO. Nine of 13 had concomitant chondral, meniscal, or ligamentous procedures performed. The mean alignment correction was 8° (range 5°-13°). All patients were able to successfully return to sport at a mean of 11 months (range 9-13 months). Furthermore, all 13 patients demonstrated an improvement in both Marx Activity Scale (4-11; P < 0.01) and IKDC scores (53-89; P < 0.01) after surgery. Conclusions Correction of valgus knee malalignment through DFVO—either medial closing wedge or lateral opening wedge—can reliably result in improvement in function and return to sport. Concomitant chondral, meniscal, and ligamentous pathology should be addressed.

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Mortimer, J. Alexandra, Maryse Bouchard, Anna Acosta, and Vincent Mosca. "The Biplanar Effect of the Medial Cuneiform Osteotomy." Foot & Ankle Specialist 13, no. 3 (2019): 250–57. http://dx.doi.org/10.1177/1938640019868061.

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Background. The “foot-CORA” (center of rotation of angulation) method confirms the medial cuneiform as the site of deformity in most forefoot/midfoot deformities and is therefore the ideal location to correct those deformities. It has been consistently observed intraoperatively by the senior author that there is a secondary, unintentional deformity created in the transverse plane when dorsiflexion and plantar flexion osteotomies of the medial cuneiform are performed to correct pronation and supination forefoot deformities, respectively. These effects may not be desirable. This biplanar effect of medial cuneiform osteotomies has been observed but not studied. The purpose of this study was to perform the 4 commonly used medial cuneiform osteotomy techniques on cadaveric feet to demonstrate their biplanar effects. Methods. Four formaldehyde preserved cadaveric feet were used to perform 4 techniques of medial cuneiform osteotomy: dorsiflexion plantar-based opening wedge, plantar flexion dorsal-based opening wedge, dorsiflexion dorsal-based closing wedge, and plantar flexion plantar-based closing wedge. Photographs and fluoroscopy were used to assess the angular changes in the sagittal and transverse planes. Angular measurements were made using OsiriX software on fluoroscopic images. Results. The medial cuneiform opening wedge osteotomies produced midfoot abduction in addition to the desired dorsiflexion and plantar flexion. The medial cuneiform closing wedge osteotomies produced midfoot adduction in addition to the desired dorsiflexion and plantar flexion. Conclusion. We confirm that intentional sagittal uniplanar osteotomies of the medial cuneiform create obligate biplanar effects. This is likely a result of tethering by ligaments and the joint capsules on the lateral border of the medial cuneiform. The obligate transverse plane effect can be used to one’s advantage or result in an undesired effect if not considered during surgical planning and execution. We propose a simple treatment algorithm for selecting the appropriate medial cuneiform osteotomy for forefoot/midfoot deformities. Levels of Evidence: Level V

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Jahss, Melvin H., Allen I. Troy, and Frederick Kummer. "Roentgenographic and Mathematical Analysis of First Metatarsal Osteotomies for Metatarsus Primus Varus: A Comparative Study." Foot & Ankle 5, no. 6 (1985): 280–321. http://dx.doi.org/10.1177/107110078500500602.

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The operative effectiveness of five different first metatarsal osteotomies for nonarthritic hallux valgus and metatarsus primus varus were objectively evaluated roentgenographically. The series consisted of 120 feet (75 patients) seen over a 5-year period. The osteotomies were biplanar neck, Chevron, biplanar basilar, basilar concentric, and basilar concentric combined with a lateral closing wedge. All the osteotomies except for the Chevron had varying degrees of plantar displacement of the distal fragment and crossed Kirschner wire fixation. The operative techniques and failures are discussed. Special x-ray studies confirmed misleading pseudocorrections caused by bandage compression and intraoperative and early postoperative roentgenographic distortion. The Chevron gave the least correction, 2°, and did not permit plantar displacement to obviate late metatarsal transfer lesions. The biplanar neck osteotomies were technically the simplest, giving 86% satisfactory corrections, averaging 4.3°. The biplanar basilar osteotomies yielded the most erratic results. The poor results were due to medial tilt during fixation, thereby negating any correction. The technical difficulties with the basilar concentric osteotomy were overcome by the addition of a small lateral closing wedge. This procedure gave by far the most consistently good results with corrections of up to 12°, averaging 7.9°.

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Liska, Franz, Bernhard Haller, Andreas Voss, et al. "Smoking and obesity influence the risk of nonunion in lateral opening wedge, closing wedge and torsional distal femoral osteotomies." Knee Surgery, Sports Traumatology, Arthroscopy 26, no. 9 (2017): 2551–57. http://dx.doi.org/10.1007/s00167-017-4754-9.

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Tan, Si Heng Sharon, Si Jian Hui, Chintan Doshi, Keng Lin Wong, Andrew Kean Seng Lim, and James Hoipo Hui. "The Outcomes of Distal Femoral Varus Osteotomy in Patellofemoral Instability: A Systematic Review and Meta-Analysis." Journal of Knee Surgery 33, no. 05 (2019): 504–12. http://dx.doi.org/10.1055/s-0039-1681043.

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AbstractDistal femoral varus osteotomies have been novelly described in the recent years to be successful in the management of patellofemoral instability with genu valgum. However, these publications are limited to case reports and small case series and no published literature have attempted to analyze them in totality. The current review aims to pool together these small case series to evaluate the outcomes and complications of distal varus femoral osteotomies when performed for patellofemoral instability. The review was conducted using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. All studies that reported the outcomes of distal femoral varus osteotomy for patellofemoral instability were included. A total of five publications were included in the review, which included a total of 73 patients. All of the studies reported improvement in the radiological outcomes for genu valgum correction and patellofemoral instability. One study using opening wedge osteotomy reported a decrease in Caton–Deschamps index postoperatively, while another study using closing wedge osteotomy reported maintenance of the Caton–Deschamps index postoperatively. Second look arthroscopy showed an improvement in the status of the chondral lesions of the medial facet of the patellar undersurface, the lateral facet of the patellar undersurface and the trochlear groove 2 years postoperatively. All studies also reported a decrease in the risk of recurrence of patellofemoral instability, reduction in pain, and an improvement in all the clinical outcomes knee scores. Distal femoral varus osteotomy is promising and useful in the management of patellofemoral instability with genu valgum. The procedure can allow for radiological correction of the genu valgum and patellofemoral instability, reduction in the risk of recurrence of patellofemoral instability, reduction in pain, improvement in clinical knee outcome scores, and improvement in the status of the chondral lesions in the patellofemoral joint. It is highly versatile and could accommodate varying degrees of correction. These improvements in radiological and clinical outcomes can be seen in studies for both closing wedge and opening wedge distal femoral osteotomies. However, opening wedge osteotomies appear to decrease the patellar height as compared with closing wedge osteotomies which maintain the patellar height; therefore, the patellar height should be assessed preoperatively prior to deciding whether to perform an opening wedge or closing wedge distal femoral varus osteotomy. The Level of Evidence for this study is IV.

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Shim, Jong Sup, Eunjin Sul, Haechan Ha, and Chang Young Kim. "Lateral Closing Wedge Supracondylar Osteotomy of the Humerus in Children with Cubitus Varus Deformity." Journal of the Korean Orthopaedic Association 43, no. 1 (2008): 17. http://dx.doi.org/10.4055/jkoa.2008.43.1.17.

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Devnani, A. S. "Lateral closing wedge supracondylar osteotomy of humerus for post-traumatic cubitus varus in children." Injury 28, no. 9-10 (1997): 643–47. http://dx.doi.org/10.1016/s0020-1383(97)00139-3.

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Kamal, Younis, Snobar Gul, Javaid Ahmed, Murtaza Fazal Ali, and Bilal Ahmad Lone. "Cubitus varus deformity in young adults, Correction by rigidly fixed lateral closing wedge osteotomy." Indian Journal of Orthopaedics Surgery 5, no. 2 (2019): 141–44. http://dx.doi.org/10.18231/j.ijos.2019.026.

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Soejima, Osamu, Hiroyuki Iida, Shun Komine, Tomomi Kikuta, and Masatoshi Naito. "Lateral closing wedge osteotomy of the distal radius for advanced stages of Kienböck's disease." Journal of Hand Surgery 27, no. 1 (2002): 31–36. http://dx.doi.org/10.1053/jhsu.2002.30906.

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Böhler, M., F. K. Fuss, W. Schachinger, G. Wölfl, and K. Knahr. "Loss of correction after lateral closing wedge high tibial osteotomy - a human cadaver study." Archives of Orthopaedic and Trauma Surgery 119, no. 3-4 (1999): 232–35. http://dx.doi.org/10.1007/s004020050399.

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Kurashige, Toshinori, and Seiichi Suzuki. "Effectiveness of Percutaneous Proximal Closing Wedge Osteotomy With Akin Osteotomy to Correct Severe Hallux Valgus Determined by Radiographic Parameters." Foot & Ankle Specialist 10, no. 2 (2016): 170–79. http://dx.doi.org/10.1177/1938640016668031.

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Some authors reported the results from percutaneous distal metatarsal osteotomy for hallux valgus recently. On the other hand, there are few reports of percutaneous proximal metatarsal osteotomy. The purpose of the present study was to evaluate the radiographic results of percutaneous proximal closing wedge osteotomy with Akin osteotomy for correction of severe hallux valgus and increasing longitudinal arch height. Consecutive 17 feet (mean age = 70.8 years) were investigated. The mean follow-up was 22 months. Excision of medial eminence, distal soft tissue release, and Akin osteotomy were all performed percutaneously and concurrently. Weight-bearing anteroposterior and lateral radiographs of the feet were acquired preoperatively and at final follow-up. On the anteroposterior radiographs, hallux valgus angle, intermetatarsal angle, and first metatarsal shortening were measured. On the lateral radiographs, talometatarsal angle, calcaneal pitch angle, and first metatarsal dorsiflexion were measured. The average improvements in hallux valgus angle and intermetatarsal angle were 27.6° and 9.9°, respectively. The average first metatarsal shortening was 2.7 mm. The first metatarsal dorsiflexion improved by 2.2°; however, other parameters did not improve significantly. In conclusion, percutaneous proximal closing wedge osteotomy with Akin osteotomy corrects severe hallux valgus; however, the procedure does not increase the medial longitudinal arch. Levels of Evidence: Therapeutic, Level IV: Case series

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Kim, Joong Il, Hyuk Soo Han, Sahnghoon Lee, and Myung Chul Lee. "Medial opening-wedge high tibial osteotomy affects leg length whereas a lateral closing-wedge osteotomy does not: a systematic review." Journal of ISAKOS: Joint Disorders & Orthopaedic Sports Medicine 2, no. 2 (2017): 75–80. http://dx.doi.org/10.1136/jisakos-2016-000086.

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Parthasarathy, RT. "CUBITUS VARUS DEFORMITY IN ADULTS TREATED WITH LATERAL CLOSING WEDGE OSTEOTOMY AND FIXATION WITH PLATE." International Journal of Orthopaedics Traumatology & Surgical Sciences 5, no. 1 (2019): 55–58. http://dx.doi.org/10.47618/ijotss/v5i1.8.

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Moon, Myung-Sang, Sung-Soo Kim, Seong-Tae Kim, et al. "Lateral Closing Wedge Osteotomy with or without Medialisation of the Distal Fragment for Cubitus Varus." Journal of Orthopaedic Surgery 18, no. 2 (2010): 220–23. http://dx.doi.org/10.1177/230949901001800217.

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