Comparative analysis of clinical and functional outcomes in late adolescents with genu valgum undergoing corrective osteotomy: a study of K-wire fixation versus plate osteosynthesis

Abstract

Background: Knee alignment typically transitions from varus to valgus during growth, stabilizing around 6° valgus by age 11, with interventions necessary for exaggerated valgus in adolescence. Surgical options for genu valgum correction involve osteotomy or guided growth procedures, with distal femur osteotomy being common in late adolescents and adults, though limited literature exists on outcomes with Kirschner wires (K-wires) and plate fixation. A prospective study is proposed to assess clinical, radiological, and functional outcomes in correcting genu valgum from the distal femur. Methods: A prospective, randomized, single-center clinical trial with 50 patients with genu valgum deformity not responsive to conservative management. Patients underwent thorough pre-operative evaluation followed by medial closed wedge osteotomy with K-wire or plate fixation. Assessment at 24 weeks included Bostman et al knee scoring, visual analog scale (VAS), passive range of motion evaluation, Likert scale and findings were compared. Results: Cohort of 50 patients, comprising 55% females and 45% males, with a mean age of 20.76 years, no significant differences were observed in age distribution or gender between the two treatment groups (K wire fixation and plate osteosynthesis). At 24 weeks, there were no significant differences between the groups in terms of Bostman knee score, VAS score, or range of motion, indicating similar outcomes with both treatment modalities. Conclusions: Distal femoral medial closing wedge osteotomy with K-wire fixation offers a cost-effective and practical solution for genu valgum correction, particularly beneficial in resource-limited settings like India, providing comparable outcomes to plate fixation in late adolescents.