Genu valgum deformity correction by distal femur translation osteotomy and anterograde intramedullary nailing

Background: Corrective ostetomy for deformity correction in adult patient with genu valgum has been performed in past but associated with many complications like wound complications, hardware irritation, delayed union long period of immobilization. Here we use intramedullary nailing along with osteotomy to reduce these complications. Material and Method: 22 osteotomy (7 females, 15 males) with moderate to severe genu valgum (Intermalleolar distance more than 10 cm) with age > 12 years who presented to the OPD department, where epiphysial stapling is unpredictable, were selected. 4 patients had bilateral disease. 2 patients had metabolic disorder. Rest all patients had idiopathic genu valgum. Results: 22 osteotomy, with mean age of 20.6 of which 7 were female and 15male were performed for deformity correction over femur interlocking nail. Patient were discharged after 4 post-operative day and advised physiotherapy. Patient advised follow up after 1 month, 3month, 6month, 1 year and 2 years. All osteotomies united within 3 months except in 3 patient which showed union after 4month duration. There were no cases compartment syndrome, neurovascular injury, limb length discrepancy, implant failure, delayed union and malunion. Full range of motion were achieved post operatively at hip and knee joint. Pre op and Post op difference in intermalleolar distance, tibiofemoral angle, mean lateral distal femoral angle and mean mechanical axis of deviation was found to be statistically significant. Conclusion: We conclude that translation osteotomy, being closest to the apex of the deformity i.e. The knee, is a biomechanically sound osteotomy, which leads to complete axial realignment and excellent apposition of osteotomy fragments without limb length alteration.