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Predicting translational deformity following opening-wedge osteotomy for lower limb realignment.

Barksfield RC, Monsell FP - Strategies Trauma Limb Reconstr (2015)

Bottom Line: A simulated model was developed using TraumaCad online digital software suite (Brainlab AG, Germany).Osteotomies were simulated in the distal femur, proximal tibia and distal tibia for nine sets of lower limb scanograms at incremental distances from the CORA and the resulting translational deformity recorded.There was excellent agreement between the predictive algorithm and simulated translational deformity for all nine simulations (correlation coefficient 0.93-0.99, p < 0.0001).

View Article: PubMed Central - PubMed

Affiliation: Bristol Royal Hospital for Children, Paul O'Gorman Building, Upper Maudlin Street, Bristol, BS2 8BJ, UK. rcbarksfield@hotmail.com.

ABSTRACT
An opening-wedge osteotomy is well recognised for the management of limb deformity and requires an understanding of the principles of geometry. Translation at the osteotomy is needed when the osteotomy is performed away from the centre of rotation of angulation (CORA), but the amount of translation varies with the distance from the CORA. This translation enables proximal and distal axes on either side of the proposed osteotomy to realign. We have developed two experimental models to establish whether the amount of translation required (based on the translation deformity created) can be predicted based upon simple trigonometry. A predictive algorithm was derived where translational deformity was predicted as 2(tan α × d), where α represents 50 % of the desired angular correction, and d is the distance of the desired osteotomy site from the CORA. A simulated model was developed using TraumaCad online digital software suite (Brainlab AG, Germany). Osteotomies were simulated in the distal femur, proximal tibia and distal tibia for nine sets of lower limb scanograms at incremental distances from the CORA and the resulting translational deformity recorded. There was strong correlation between the distance of the osteotomy from the CORA and simulated translation deformity for distal femoral deformities (correlation coefficient 0.99, p < 0.0001), proximal tibial deformities (correlation coefficient 0.93-0.99, p < 0.0001) and distal tibial deformities (correlation coefficient 0.99, p < 0.0001). There was excellent agreement between the predictive algorithm and simulated translational deformity for all nine simulations (correlation coefficient 0.93-0.99, p < 0.0001). Translational deformity following corrective osteotomy for lower limb deformity can be anticipated and predicted based upon the angular correction and the distance between the planned osteotomy site and the CORA.

No MeSH data available.


Related in: MedlinePlus

Simulated and predicted data for correction of distal femoral deformities. There was strong correlation between translational deformity and increasing distance of the osteotomy from the CORA in the simulated model. In addition, there was strong correlation between predicted translation and the translation measured during simulation
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Fig4: Simulated and predicted data for correction of distal femoral deformities. There was strong correlation between translational deformity and increasing distance of the osteotomy from the CORA in the simulated model. In addition, there was strong correlation between predicted translation and the translation measured during simulation

Mentions: Data for the distal femoral deformities are presented in Fig. 4. The correlation coefficient between distance of the osteotomy from the CORA and translational deformities produced was 0.99 (p < 0.0001) for all femurs studied.Fig. 4


Predicting translational deformity following opening-wedge osteotomy for lower limb realignment.

Barksfield RC, Monsell FP - Strategies Trauma Limb Reconstr (2015)

Simulated and predicted data for correction of distal femoral deformities. There was strong correlation between translational deformity and increasing distance of the osteotomy from the CORA in the simulated model. In addition, there was strong correlation between predicted translation and the translation measured during simulation
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4666231&req=5

Fig4: Simulated and predicted data for correction of distal femoral deformities. There was strong correlation between translational deformity and increasing distance of the osteotomy from the CORA in the simulated model. In addition, there was strong correlation between predicted translation and the translation measured during simulation
Mentions: Data for the distal femoral deformities are presented in Fig. 4. The correlation coefficient between distance of the osteotomy from the CORA and translational deformities produced was 0.99 (p < 0.0001) for all femurs studied.Fig. 4

Bottom Line: A simulated model was developed using TraumaCad online digital software suite (Brainlab AG, Germany).Osteotomies were simulated in the distal femur, proximal tibia and distal tibia for nine sets of lower limb scanograms at incremental distances from the CORA and the resulting translational deformity recorded.There was excellent agreement between the predictive algorithm and simulated translational deformity for all nine simulations (correlation coefficient 0.93-0.99, p < 0.0001).

View Article: PubMed Central - PubMed

Affiliation: Bristol Royal Hospital for Children, Paul O'Gorman Building, Upper Maudlin Street, Bristol, BS2 8BJ, UK. rcbarksfield@hotmail.com.

ABSTRACT
An opening-wedge osteotomy is well recognised for the management of limb deformity and requires an understanding of the principles of geometry. Translation at the osteotomy is needed when the osteotomy is performed away from the centre of rotation of angulation (CORA), but the amount of translation varies with the distance from the CORA. This translation enables proximal and distal axes on either side of the proposed osteotomy to realign. We have developed two experimental models to establish whether the amount of translation required (based on the translation deformity created) can be predicted based upon simple trigonometry. A predictive algorithm was derived where translational deformity was predicted as 2(tan α × d), where α represents 50 % of the desired angular correction, and d is the distance of the desired osteotomy site from the CORA. A simulated model was developed using TraumaCad online digital software suite (Brainlab AG, Germany). Osteotomies were simulated in the distal femur, proximal tibia and distal tibia for nine sets of lower limb scanograms at incremental distances from the CORA and the resulting translational deformity recorded. There was strong correlation between the distance of the osteotomy from the CORA and simulated translation deformity for distal femoral deformities (correlation coefficient 0.99, p < 0.0001), proximal tibial deformities (correlation coefficient 0.93-0.99, p < 0.0001) and distal tibial deformities (correlation coefficient 0.99, p < 0.0001). There was excellent agreement between the predictive algorithm and simulated translational deformity for all nine simulations (correlation coefficient 0.93-0.99, p < 0.0001). Translational deformity following corrective osteotomy for lower limb deformity can be anticipated and predicted based upon the angular correction and the distance between the planned osteotomy site and the CORA.

No MeSH data available.


Related in: MedlinePlus