2025 ISAKOS Biennial Congress ePoster
Small Changes Of Femoral Torsion After Distal Femoral Osteotomy Using Patient-Specific Instruments Even In Case Of A Hinge Fracture
Lukas Jud, MD, Zurich SWITZERLAND
Georgios Neopoulos, MD, Zurich SWITZERLAND
Sandro Hodel, MD, Zurich SWITZERLAND
Lazaros Vlachopoulos, MD, PhD, Zurich SWITZERLAND
Sandro Fucentese, Prof MD, Zuerich, CH SWITZERLAND
Balgrist University Hospital, Zurich, Zurich, SWITZERLAND
FDA Status Not Applicable
Summary
The use of patient-specific instrumentation in varus and valgus distal femoral osteotomy results in only low changes of the femoral torsion, even if a hinge fracture occurs.
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Abstract
Background
Hinge fractures show a relatively high incidence in varus and valgus distal femoral osteotomy (DFO) and can lead to delayed- or non-union. Another observed complication of a hinge fracture is an unintentional change of the postoperative femoral torsion of up to +9.5° in conventionally performed DFO.
Purpose
To analyze the change of femoral torsion in case of a hinge fracture when DFO is performed using patient-specific instruments (PSI).
Study Design
Case Series
Methods
All patients who underwent varus or valgus DFO using PSI from January 2014 to September 2023 were included. Radiographs and computed tomography (CT) scans were used to screen for hinge fractures. Pre- and postoperative femoral torsion was measured in CT.
Results
Thirty-five medial closing-wedge DFO (MCW-DFO), 27 lateral closing-wedge DFO (LCW-DFO), and 27 lateral opening-wedge DFO (LOW-DFO) were included, resulting in a total of 89 included osteotomies. A total of 55 hinge fractures (61.8%) were observed. The femoral torsion changed significantly from 20.5° ± 7.7° to 15.5° ± 8.1° (p < 0.001) in LOW-DFO with a hinge fracture, whereas the other two techniques showed no significant change of femoral torsion.
Conclusion
The use of PSI in varus and valgus DFO showed only small changes of the postoperative femoral torsion, even in case of a hinge fracture. The change of femoral torsion was depending on the type of DFO and was only significant in LOW-DFO, however, not exceeding a mean change of 5°.