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Correction of coronal, rotational deformity and shortening in a paediatric femur using Ilizarov technique – A case report

Volume 6 | Issue 1 | Jan – April 2020 | Page: 16-19 | Ramprasath Ramlal Dhurvas, Vetrivel Chezian Sengodan, Surendar Vellaiyan


Authors : Ramprasath Ramlal Dhurvas [1], Vetrivel Chezian Sengodan [1], Surendar Vellaiyan [1]

[1] Institute of Orthopaedics and Traumatology, Coimbatore Medical College Hospital (The TN Dr.MGR Medical University) Coimbatore, Tamil Nadu, India.

Address of Correspondence
Dr. Ramprasath Ramlal Dhurvas,
12/23, Murugappa street, Purasaiwakkam, Chennai, Tamil Nadu, India
E-mail: dhurvasramprasath@gmail.com


Abstract

Background: Deformities in femur in children usually involves more than one axis with angular as well as displacement components. Moreover, the remaining growth in the opposite limb necessitates adequate lengthening of the ipsilateral limb.
Case Details: A 9 year old female child presented with genu varum deformity and shortening of 8 cm. X ray revealed the deformity to be localized to distal femur. CT (computed tomography) showed physeal bar in the medial half of distal femoral physis. We performed corrective osteotomy just proximal to the CORA (center of rotation of angulation) and corrected the deformity using Ilizarov apparatus, following which lengthening was done using same apparatus.
Results: A lengthening of 10 cm (over lengthening) was achieved with a lengthening index of 1.4 cm/month. Varus deformity was slightly over corrected to 5 degree of valgus. The range of motion of knee two months after fixator removal was 20 degree. One major complication in the form of regenerate fracture was encountered when the fixator was insitu. This was managed by reapplication of the pins. We achieved correction of varus, internal rotation, and shortening in the right femur.
Conclusion: Multiplanar deformities in children need prolonged treatment after corrective osteotomy. Ilizarov fixator provides the required mechanical stability as well as versatility to achieve this goal. Prolonged physiotherapy is necessary to restore the range of motion after fixator removal.
Key words: Multiplanar deformity, Ilizarov, osteotomy, lengthening, Paediatric femur
MeSH terms: Femur, rotation, Osteotomy, Genu varum, Bone lengthening


References 

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How to Cite this Article: Dhurvas R R, Sengodan V C, Vellaiyan S.| Correction of coronal, rotational deformity and shortening in a paediatric femur using Ilizarov technique – A case report.| International Journal of Paediatric Orthopaedics | Jan-April 2020; 6(1): 20-23.

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