Gradual Correction of Valgus Deformities of the Tibia Using a Monolateral External Fixator

D P Motta; Jlr Faria; A Couto; D P Aguiar; Mvg Amaral; L L Kropf; Gava Motta; F S Cerqueira; B D Leonetti

doi:10.5005/jp-journals-10080-1585

Gradual Correction of Valgus Deformities of the Tibia Using a Monolateral External Fixator

Strategies Trauma Limb Reconstr. 2023 May-Aug;18(2):123-132. doi: 10.5005/jp-journals-10080-1585.

Authors

D P Motta¹, Jlr Faria², A Couto³, D P Aguiar⁴, Mvg Amaral⁵, L L Kropf¹, Gava Motta¹, F S Cerqueira¹, B D Leonetti¹

Affiliations

¹ Center for Specialized Care of the Treatment Area of Dysmetry and Deformities of the Locomotor System, National Institute of Traumatology and Orthopedics, Rio de Janeiro, Brazil.
² Center for Specialized Care of Knee Surgery, National Institute of Traumatology and Orthopedics, Rio de Janeiro, Brazil.
³ National Institute of Traumatology and Orthopedics, Rio de Janeiro, Brazil.
⁴ Biophysics Chair, State University of Rio de Janeiro, Brazil.
⁵ Center for Specialized Care Shoulder and Elbow Surgery, National Institute of Traumatology and Orthopedics, Rio de Janeiro, Brazil.

Abstract

Objective: To present a review of patients subjected to gradual correction of a valgus deformity of the tibia using a monolateral external fixator.

Method: This retrospective review included patients from January 2012 to May 2022 who met the following inclusion criteria: deviation of mechanical axis of the limb due to valgus deformity of the tibia; tibial deformity in the coronal plane on radiographic examination; a documented outpatient pre-operative evaluation by an orthopaedic surgeon and age between 10 and 70 years. The following exclusion criteria were applied: the presence of another tibia deformity preventing gradual correction using the proposed assembly; skin conditions incompatible with the surgical procedure; inadequate pre- or post-operative radiological evaluation; and insufficient information in the medical records.

Results: The mean age of patients with a valgus deformity of the tibia was 30.8 ± 15.9 years. These patients had a body mass index (BMI) of 26.1 ± 5.5 kg/m². A congenital or developmental aetiology was attributed to 58.3% of the cases. Most commonly, the deformity was found in the middle third of the tibia with a mean deformity of 14.7 ± 6.6 degrees. The total external fixator time ranged from 73 to 229 days (average 149.7 ± 36.1 days). The mean medial proximal and lateral distal tibial angles differed significantly for pre- and post-operative measurements (p ≤ 0.05). There were complications in eight cases; five cases of pin site infections, two cases of medial cortical fracture and one case of peroneal nerve neuropraxia.

Conclusion: The proposed correction technique produces a satisfactory angular correction and with similar outcomes as described in the literature.

How to cite this article: Motta DP, Faria JLR, Couto A, et al. Gradual Correction of Valgus Deformities of the Tibia Using a Monolateral External Fixator. Strategies Trauma Limb Reconstr 2023;18(2):123-132.

Keywords: External fixation; Monolateral; Osteotomy; Tibia deformity; Valgus.