MOJ
eISSN: 2374-6939
Submit manuscript...
Clinical Report Volume 15 Issue 2
Genu varum (Rt) genu valgum (Lt), post traumatic ankle varus deformity (Lt)
Bari MM,1 
Verify Captcha
Regret for the inconvenience: we are taking measures to prevent fraudulent form submissions by extractors and page crawlers. Please type the correct Captcha word to see email ID.
Bari AM Shayan R2
Verify Captcha
Regret for the inconvenience: we are taking measures to prevent fraudulent form submissions by extractors and page crawlers. Please type the correct Captcha word to see email ID.
1Prof. Ph.D, Chief Consultant, Bari-Ilizarov Orthopaedic Centre, Visiting and Honored Prof., Russian Ilizarov Scientific Centre, Russia
2Medical officer, Bari-Ilizarov Orthopaedic Centre; PhD resident in Tashkent scientific research institute of orthopaedics and traumatology, Uzbekistan
3Prof., Bari-Ilizarov Orthopaedic Centre, Bangladesh
Correspondence: Bari MM, Bari-Ilizarov Orthopaedic Centre, 1/1, Suvastu Shirazi Square, Lalmatia Block E, Dhaka-1207, Bangladesh, Tel +8801819211595
Received: April 05, 2023 | Published: April 24, 2023
Citation: Bari MM, Bari AM, Shayan R, et al. Genu varum (Rt) genu valgum (Lt), post traumatic ankle varus deformity (Lt). MOJ Orthop Rheumatol. 2023;15(2):84-85. DOI: 10.15406/mojor.2023.15.00622
Abstract
Ilizarov Technique is a fantastic tool for correcting femoral varus, genu valgum and ankle varus. The case demonstrates an approach to large complex deformity in both right & left knee, and left ankle region. All of the aforementioned deformities were fully corrected by the help of Ilizarov Technique.1,2,3
Clinical history
A 21 years old boy sustained motor vehicle injury in the left inferior extremity at the age of 4. He was treated at Combined Military Hospital, Dhaka at that time because father is an Army personnel. Now, he was referred to Bari-Ilizarov Orthopaedic Centre for further management, that is for correction of deformity and L. L. D. Plain X-ray and clinical findings showed his right genu varum deformity due to depressed medial tibial plateau and lower (Lt) tibio fibular varus and procurvatum deformity and left knee genu valgum. His father was anxious regarding his deformity correction.4,5 (Figure 1(A-E))
Figure 1(A-E)
(A) Front view of the patient with procurvatum deformity of tibia (Lt) é ankle varum
(B) Back view of the patient
(C) Patient Side view showing procurvatum deformity
(D) Radiograph of lower (Lt) tibio fibular varus and procurvatum deformity.
(E) Bipedal full length stress X-ray.
Problems before surgery
Obesity
Gradually worsening of deformity and skeletal maturity Right sided genu varum, left sided valgum and Lt ankle varus
Treatment plan
Two steps of surgeries were calculated.
- Gradual medial opening wedge osteotomy in the upper Rt tibia with Ilizarov techniques.
- Gradual correction of left genu valgum; and simultaneoustly gradual correction of procurvatum and varum deformity by osteotomy in true apex of the deformity and followed by lengthening.
What we hope to achieve
Our aim is to achieve
Waund gait
Eliminating any preexisting LLD
Allow full weight bearing é minimal stiffness of joints
Increase quality of life
Why Ilizarov method?
Ilizarov compression-distraction device provides flexibility and adaptability
Advantages of Ilizarov
Minimally invasive
Allow weight bearing from 1st POD
Early mobilization
Other advantages of Ilizarov
Modular
Customizable
Can treat multilevel, multiplanar and multi-directional deformities
Can articulate across the joints
During treatment images, radiographs and follow up (Figure 1(F-H))
Figure 1(F-H)
(F) Patient lying on operation table during application of Ilizarov apparatus
(G) Patient with Ilizarov apparatus
(H) Correction of deformity with Ilizarov apparatus in stu
Technical pearls
- 3 rings in Rt tibia é osteotomy done in between 1st and 2nd ring (tibia); osteotomy of fibula (both 2nd and 3rd ring)
- 3 rings in left tibia and half ring in calcaneum and metatarsals. Osteotomy done in between 2nd and 3rd ring both tibia and fibula.
Post-operative management and rehabilitation
Exercises were encouraged just day after the pain permitted.
Cleansing the wire sites at regular interval.
Discharged with follow-up every weeks until radiological signs of union.
Apparatus removed with outdoor or indoor basis. (Figure 1(I-L))
Figure 1(I-L)
(I)With long leg plaster immobilization after dismounting the Ilizarov apparatus.
(J) Bipedal full length stress X-ray.
(K) Final follow up after full correction (Front view of the patient).
(L) Final follow up after full correction (Back view of the patient)
Acknowledgments
None.
Conflicts of interest
The authors declare no conflicts of interest.
References
- Bari MM. A color atlas of limb lengthening, surgical reconstruction and deformity correction by llizarov technique. 2013;286–295.
- llizarov GA. Transosseous Osteosynthesis. Theoretical and clinical aspects of the regeneration and growth of tissue. Springer-Verlag Berlin Heidelberg. Germany. 1992. pp. 495.
- Bari MM. llizarov (Compression-distraction) method in Paediatric Orthopaedics llizarov technique. Medcrave. 2016;227–224.
- Bari MM. Correction of leg deformities and restoration of function of leg bones by Ilizarov technique. 2016;125.
- Paley D. Principles of deformity correction. Knee extension contracture. Orthopedics. Springer, 2000:563–567.
©2023 Bari, et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.